LIBRARY OF CONGRESS..* 



'| la P foRrisM |o. .-: | J 

| UNITED STATES OF AMERICA f 



# 



A. M^HSTTT^L 



OF 



BANDAGING 



ADAPTED FOR SELF-INSTRUCTION. 



/ 

By C. HENRI LEONARD, M. A., M. D. 



WITH OVER ONE-HUNDRED ILLUSTRATIONS. 



'a 



7 



2 



67 J 






DETROIT: 

DAILY POST BOOK PBINTING ESTABLISHMENT. 
1876. 




-rt 



3 



Entered according to Act of Congress, in the year 1875, 

*By C. HENRI LEONARD, 

in the office of the Librarian of Congress at Washington. 



6,000 COPIES SOLD FIRST YEA.K, 

The Multum in Parvo Dose Book. 

BY C. HENRI LEONARD, M. A. 7 M. D. 

Second Edition, Revised and Enlarged. Paper, 60 cts.; Cloth, 75 cts. 

Contains the doses of more remedies than any other Dose Book or 

Materia Medica published, and is used in nearly every Medical 

College of the United States, and by Physicians and Druggists 

in every State and Territory, and the Canada s. 

CONTENTS: Medium and maximum Doses of all officinal and nonofficinal remedies 
and their preparations ( emetic doses indicated , arranged in alphabetical order : Pro- 
nunciation of each : the Orthography that of the last U. S. P. The nonofficinal reme- 
dies are indicated. Full list of Preparations, as waters, plasters, pills, etc., and pronunci- 
ation. Rules for Genitive-case endings in prescription writing. A complete list of In- 
compatibles Ditto of Poisons and their Antidotes, and Tests for each. Also rules for 
resuscitation of the drowned, treatment of poisoned wounds, etc. Complete table of Tests 
for Urinary Deposits, chemical and microscopical. Full series of Obstetric Tables, and 
rules for management in difficult cases and accidents. Pronunciation of Medico-Biogra- 

Bhical Names. Table of Fees for city and country practice, taken from the Philadelphia 
etroit, and New Jersey lists. Series of Visceral Measurements as guides for auscultation 
and percussion. The National Code of Ethics (condensed), and the Hippocratic Oath. 
Table of the Exanthemata, and differential diagnosis Tables of Weights, Measures, 
both French and American, and for apportioning doses, etc. List of Abbreviations, be- 
sides several pages of miscellaneous matter, useful in emergencies, accidents, etc. 

What the Press say: " Is emphatically a multum in parvo * * * and contains 
a fund of valuable information of every day requirement. * * Besides being the most 
complete Dose Book we knew of, it is indispensable to the practitioner on account of its 
other contents." — Peninsular Journal of Medicine. " Every one must acknowledge that 
this author has compressed an immense amount of ready practical information into the 
minimum of space."— Chicago Medical Journal and Examiner. "Is just what every 
physician and druggist should have in his pocket for immediate reference."— Michigan 
Farmer. 



THE VEST-POCKET jlNATOMIST. 

By C. HENRI LEONARD, M. A., M. D. 

Enlarged Edition — Paper 50 cents. Used in nearly every Medical College of 
the United States. 

CONTENTS : Each Bone : its name ; pronunciation ; the points of interest ; the num- 
ber and names of muscles attached (those of insertion being indicated by different type); 
number of articulations, and names of bones articulating; number of developmental 
centers, and time of first appearance. Each Muscle: its name ; origin; insertion ; ner- 
vous supply ; pronunciation, etc. Each Artery; : its name ; number of branches, from 
main vessel ; pronunciation of each : origin ; course ; structures supplied ; anastomosis. 
(Given in successive order of origin ; the main vessels indicated by larger tpye.) Each 
Vbin : its name ; pronunciation ; course ; where emptying ; vessels received ; number of 
valves etc. Each Nerve : its name ; pronunciation ; origin ; course ; branches : distribution ; 
anastomosis, etc. (Main branches indicated by larger type.) Complete resume Table 
of the bones. Classified Table of the actions of the muscles. 

"Brief, comprehensible, and to the point; in fact it is 'Gray' and 'Wilson' in a 
" short dress." The departments named are complete ; something you cannot say of the 
small anatomies heretofore issued."— Medical Observer. 
|3F~Either book will be sent post-paid upon receipt of price by addressing the Publisher, 

C. HENRI LEONARD. M. D„ 

353 Woodward Avenue, Detroit, Mich. 



^e u >iultuiri ir| ^kfvo'^erie^. 



The Multum in Parvo Dose Book 



Paper, 60 cts. Cloth, 75 cts. 



THE VEST-POCKET ANATOMIST. 

Paper, 50 cts. 



MANUAL OF BANDAGING 

Fully Illustrated, 
Cloth, $1.50. 



Any of the above sent post-paid upon receipt of price by 

C. HENKI LEONARD, M. D., 

Detroit, Mich. 

Regular Discount to the Trade. 



Depots. — Eastern : D. Appleton & Co., New York City ; J. B. Lippincott 

& Co., Philadelphia; James Campbell, Boston. Southern: J. P. Morton 

& Co., Louisville. Western : Bancroft & Co., San Francisco. 



PREFACE. 



In the issue of this little Manual the author has hoped to 
meet the wants of many students of medicine, and practitioners 
who have had no opportunities for hospital drill in bandaging. 

Our text-books, in general, are very meagre in their descriptions 
and illustrations of this branch of surgery, and our "Lectures," given 
upon this topic at our medical colleges, are too often cursory and 
incomplete, from the press of, seemingly, weightier matters that 
demand attention. We have, the author believes, no work in the 
English language that is devoted exclusively to this subject. 
Several works upon " Minor Surgery," in reprints and original 
editions, are seen upon our book shelves ; yet even these offer but 
few descriptions, and have fewer illustrations — really the essential 
part of all treatises upon this art — of the various bandages. 

In this work each bandage is designed to have an illustration of 
its application. There are but a few exceptions to this rule, and 
these all are either referred to a wood-cut that answers the purpose 
sufficiently well, or else the bandage is so exceedingly simple that 
none is required. 

It will be noticed, also, that but few " double-headed " bandages 
are given. It has been the purpose of the author to omit these so 
far as possible ; thus making the book consist of the simple and 
more useful bandages, rather than those after the "fancy" and 
ornate order. 



6 PREFACE. 

A glance at the Table of Contents will show the extent of 
ground gone over, and the completeness, or incompleteness of its 
consideration. "Knots," "Poultices," " Strappings," and "Immov- 
able Bandages," are so intimately connected with the subject treated 
of at length, that it was thought advisable to introduce a few short 
chapters upon these topics. 

Gerdy's classification has been, in the main, followed for the 
Roller bandages, and Mayor's for the most of the Triangles and 
Cravats, though the author has adopted dressings from other sources 
as well. He is also under great obligations to Prof. John H. 
Lowman, of the Medical Department of the University of Wooster, 
Cleveland, Ohio, for original matter and designs received, besides 
many other courtesies extended to him. 

Thanking his other various friends for advice and assistance 

given, he awaits with interest the Manual's reception by the medical 

public. 

353 Woodward Ave., January 1st, 1876. C. H. L. 



COIsTTEIsTTS 



CHAPTER I. 
Charpie and Cotton-wool : A Plumasseau. A Gateau. A Boulette. A 
Bonrdonnet. A Tampon. A Pelote. Tents Page 13 

CHAPTER II. 

Compresses : The Square. The Graduated. The Triangular. The Rectan- 
gular. The Circular. The Complex. Those of Two, Three, Four, and 
Six Heads. The Button-Hole. The Perforated Page 16 

CHAPTER III. 

Bandages in General : Maltese Cross. A Roller. How to Make, Apply 
and Confine a Roller Page 19 

CHAPTER IV. 

Classification of Bandages: Simple Bandage. Compound Bandage. 
Regional Classification Page 24 

CHAPTER V. 

Bandages of the Head : Skull Cap. Circular of the Forehead and Eyes. 
Four-tailed Bandage of the Face. Fillet or Head-band. Triangle of the 
Face. Cross of the Eye. Triangle of the Eye. Cross of the Eyes. 
Fronto-oculo -occipital Triangle. Fronto-occipital Triangle. Occipito- 
frontal Triangle. Biparietal Triangle. Simple Cross of the Chin. 
Four-tailed Bandage of the Chin. Occipito-mental Triangle. Cross of 
the Head. Knotted Bandage of the Head. The T of the Head and 
Ear. The Perforated T of the Head and Ear. Recurrent Bandage of 
the Head. Six-tailed Bandage of the Head. Triangle of the Head. 
Double T °f tn e Nose. T of the Mouth. Invaginated Roller of the 
Upper Lip. Invaginated Roller of the Under Lip. Fronto-cervico- 
labial Triangle. Invaginated Triangle of the Under Lip. Posterior 
Cross of the Head and Neck. Four-tailed Bandage of the Head and 
Neck Page 26 



8 CONTENTS. 

CHAPTEE VI. 

Bandages of the Neck : Circular of the Neck. Cervical Cravat. Poste- 
rior Figure of 8 of the Head and the Axillae Double Posterior X of 
Head and Thorax. Fronto-dorsal Triangle. Anterior Figure of 8 of 
the Head and the Axillae. Double Anterior X of the Head and Thorax. 
Occipito-sternal Triangle. Figure of 8 of the Head and Axilla. Parieto- 
axillary Triangle and Cravat Page 47 

CHAPTEE VII. 

Bandages of the Upper Extremity : Spiral of One Finger. Posterior 
Figure of 8 of the Thumb and Wrist. Posterior Figure of 8 of the Hand 
and Wrist. Anterior Figure of 8 of the Hand and Wrist. Four-tailed 
Bandage of the Hand. Double X of the Back of the Hand and Wrist. 
Single X °f tne Back of the Hand and Wrist. Perforated X of the 
Hand and Wrist. Carpo-digito-palmar Triangle. Double Anterior X 
of the Hand and Wrist. Single Anterior X of the Hand and Wrist. 
Carpo-digito-dorsal Triangle. Spiral of all the Fingers. Spiral of the 
Fingers and the Hand. The Sheath of the Fingers. Figure of 8 Ex- 
tensor of the Hand upon the Forearm. Figure of 8 Flexor of the Hand 
upon the Forearm. Carpo-olecranon Cravat. Flexor Carpo-olecranon 
Cravat. Simple Spiral of the Forearm. Eeversed Spiral of the Superior 
Extremity. Anterior Figure of 8 of the Elbow. Posterior Figure of 8 
of the Elbow. Triangle of the Elbow. Four-tailed Bandage of the 
Elbow. Cervico-ulnar Cravat and Triangle. Spiral of the Arm. Four- 
tailed Bandage of the Shoulder. Large Oblique Triangle of the Arm 
and Chest. Triangular Front of the Forearm. Small Frcnt of the 
Hand or Forearm. Posterior Double Figure of 8 of the Elbow and the 
Opposite Axilla. . Page 54 

CHAPTEE VIII. 

Bandages of the Body : Spiral of the Chest. Spiral of the Abdomen. 
Ciicular-quadrilateral of the Chest, and Dorsal-cervico-sternal Triangle. 
Circular-quadrilateral of the Abdomen, and the Dorsal-cervico-sternal 
Triangle. Circular-quadrilateral of the Thorax and Abdomen, and the 
Dorsal Cervico-sternal Triangle. Anterior Thoracico-scapular Triangle. 
Posterior Thoracico-scapular Triangle. Figure of 8 of the Neck and 
Axilla. Cravat of the Neck and Axilla. Figure of 8 of the Shoulder and 
Opposite Axilla. Ascending Spica of the Shoulder. Simple Biaxillary 
Cravat. Compound Biaxillary Cravat. Cross of One Mamma. Triangle 
of the Mamma. Bourse of the Mamma. Cross of the Two Mammae. 
Bimammary Triangle. Posterior Figure of 8 of the Shoulders. Simple 
Dorsal Biaxillary Cravat. Compound Dorsal Biaxillary Cravat. Ante- 
rior 1 igure of 8 of the Shoulders. Simple Sternal Biaxillary Cravat. 
Compound Sternal Biaxillary Cravat Page 72 



CONTENTS. ' 9 

CHAPTER IX. 

Bandages of the Lower Extremity: Figure of 8 of One Toe. Double 
X of the Toes and Ankle. Spiral of All the Toes. Figure of 8 of the 
Foot and Ankle. Spiral of the Foot. Triangle of the Foot. Four-tailed 
Bandage of the Instep. Four-tailed Bandage of the Heel. Sheath of the 
Foot. Posterior Figure of 8 of the Knee. The Popliteal Cravat. An- 
terior Figure of 8 of the Knee. Cravat of the Knee. Testudo of the 
Knee. Spiral of the Knee. Four-tailed Bandage of the Knee. Simple 
Spiral of the Leg. Spiral of the Thigh. Reversed Spiral of the Leg. 
Reversed Spiral of the Thigh. Figure of 8 Spiral of the Extremities. 
Figure of 8 Bandage of the Extremities. Trhngle of the Leg. Four- 
tailed Bandage of the Leg. Reversed Spiral of the Inferior Extremity. 
Recurrent for an Amputated Thigh, etc. Triangle for Thigh Stump, 
etc. Maltese-cross for Thigh-stump, etc. Caputina. Tarso-patellar 
Cravat. Tarso-crural Cravat. Tarso-pelvic Cravat. Scapuio-tibial 
Triangle and Cravat. Sling of the Lower Extremity. Cross of the 
Groin. Descending Spica of the Groin. Trapezoidal X of the Groin. 
Cruro-inguinal Triangle. Cruro-pelvic Triangle. Cruro-pelvic Cravat. 
Sacro-bicrural Cravat. Double X °f the Perineum. Single T of the 
Perinseum. Perineal Cravat. Sacro-pubic Triangle. Four -tailed 
Bandage of the Hip. Coxo-pelvic Triangle. Lumbo-scrotal Triangle. 
Bourse of the Scrotum. Double X of the Trunk Page 86 

CHAPTER X. 

Immovable Dressings: The Bavarian Plaster Splint. The Common 
Plaster Dressing. Starch, or Plaster, Roller. The Silica Bandage. The 
Parrafin Bandage. Fenestrated Immovable Dressings. . . Page 

CHAPTER XI. 

Strappings: For the Foot and Ankle. For wounds. For a Testicle. For 
the Breast. For Extension of the Leg, . Page 

CHAPTER XII. 

Knots: The Surgeon's Knot. The Reef Knot. The Clove-hitch Knot. 
Gerdy's Extension Knot Page 

CHAPTER XIII. 

Cataplasmata : Cataplasma Carbonis. Cataplasma Conii. Cataplasma 
Fermenti. Cataplasma Lini. Cataplasma Sinapis. Cataplasma Sodae 
Chlorinate. Cataplasma Panis et Lactis. Oakum Poultice. How to 

Spread a Poultice. How to Apply a Poultice Page 

2 



LIST OIF ILZLiTTSTZR^TIOIsrS. 



Figure. page. 

1 Perpendicular section of a Graduated Compress, . . . .16 

2 Compress of Two Heads, . . 17 

3 Compress of Three Heads, 17 

4 Compress of Four Heads, 17 

5 Button-hole Compress, 18 

6 Perforated Compress, ' . . 18 

7 Maltese Cross, 20 

8 A Boiler, 20 

9 How to make a Eoller-head, .21 

10 Applying a Koller, 22 

11 Confining a Koller, . . . . . . . . . .23 

12 Circular of Forehead and Eyes, . . . ■ . . . . 26 

13 Fillet or Head-band, 27 

14 Cross of the Eye, 28 

15 Cross of the Eyes, 29 

16 Fronto-oculo-occipital Triangle, . . . . ... . 30 

17 Fronto-occipital Triangle, . .31 

18 Simple Cross of the Chin, 32 

19 Four-tailed Bandage of the Chin, . - 33 

20 Occipito-mental Triangle, . . . 34 

21 Cross of the Head, 35 

22 Knotted^ Bandage of the Head, 36 

23 The J of the Head and Ear, 37 

24 Perforated T of the Head and Ear, . . . . ■ . . 38 

25 Eecurrent Bandage of the Head, 39 

26 Diagram of the Six-tailed Bandage of the Head, ... 40 

27 Six-tailed Bandage of the Head, 40 

28 Triangle of the Head, 41 

29 Double T of the Nose, 42 

30 J of the Mouth, 43 

31 Invaginated Boiler of the Upper Lip, 44 

32 Fronto-cervico-labial Triangle, 45 



MANUAL OF BANDAGING. 



11 



FIGURE. PAGE. 

33 Posterior Cross of the Head and Neck, 46 

34 Posterior Figure-of-8 of the Head and Axilla?, .... 48 

35 Double Anterior X of the Head and Thorax, . . . .50 

36 Occipito-sternal Triangle, 51 

37 Figure-of-8 of the Head and Axilla, 52 

38 Parieto-axillary Triangle and Cravat, 53 

39 Spiral of One Finger, . .54 

40 Posterior Figure-of-8 of the Thumb and Wrist, .... 55 

41 Posterior Figure-of-8 of the Hand and Wrist, . . . .56 

42 Diagram for Double X of the Back of the Hand and Wrist, . 57 

43 Double T of the Back of the Hand and Wrist 58 

44 Diagram of the Perforated X of the Hand and Wrist, . . 59 

45 Perforated X of the Hand and W T rist, 59 

46 Carpo-digito-palmar Triangle, . . . . . . . 60 

47 Spiral of All the Fingers, 61 

48 Spiral of the Fingers and the Hand, 62 

49 Figure-of-8 Extensor of the Hand upon the Forearm, . . .63 

50 Carpo-olecranon Cravat, 64 

51 Anterior Figure-of-8 of the Elbow, QQ 

52 Cervico-ulnar Cravat and Triangle, 67 

53 Large Oblique Triangle of the Arm and the Chest, • . . .68 

54 Triangular Front of the Forearm, 69 

55 Small Front of the Hand or Forearm, 70 

56 Posterior Double Figure-of-8 of the Elbow and Opposite Axilla, 70 

57 Spiral of the Chest, 72 

58 Circular-quadrilateral of the Chest, and Dorsal Cervico- sternal 

Triangle, 73 

59 Anterior Thoracico-scapular Triangle, ..... 74 

60 Figure-of-8 of the Neck and Axilla, . . . . . .75 

61 Figure-of-8 of the Shoulder and Opposite Axilla, ... 76 

62 Simple Biaxillary Cravat, 77 

63 Compound Biaxillary Cravat, . 78 

64 Cross of One Mamma, .78 

65 Triangle of the Mamma, 79 

66 Diagram of the Bourse of the Mamma, 79 

67 Bourse of the Mamma, 80 

68 Cross of the two Mammae, 80 

69 Posterior Figure-of-8 of the Shoulders, 81 

70 Simple Dorsal Biaxillary Cravat, 82 

71 Compound Dorsal Biaxillary Cravat, 83 

72 Anterior Figure-of-8 of the Shoulders, 84 

73 Figure-of-8 of the Foot and Ankle, 87 



12 LIST OF ILLUSTRATIONS. 

FIGURE. PAGE. 

74 Triangle of the Foot, 88 

75 Posterior Figure-of-8 of the Knee, . . . . . . 89 

76 The Popliteal Cravat, 90 

77 Testudo of the Knee, 91 

78 Four-tailed Bandage of the Knee, 92 

79 Figure-of-8 Spiral of the Extremities, 93 

80 Figure-of-8 Bandage of the Extremities, 94 

81 Triangle of the Leg, • . . 95 

82 Eeversed Spiral of the Inferior Extremity, 96 

83 Kecurrent for Amputated Thigh, 97 

84 Triangle for Thigh Stump, . . . . . . . - . 98 

85 Maltese-cross for Thigh Stump, . . 98 

86 Diagram for Caputina, 99 

87 Caputina Applied, . 100 

88 Tarso-patellar Cravat, . . .101 

89 Scapulo-tibial Triangle and Cravat, ....'.. 102 

90 Sling of the Lower Extremity, . . . / . .103 

91 Cross of the Groin, , .103 

92 Trapezoidal T of the Groin, . , . . . ' . . .104 

93 Cruro-inguinal Triangle, 105 

94 Cruro-pelvic Cravat, 106 

95 Sacro-bicrural Cravat, . . . . . . . . 106 

96 Double T of the Perinaeum, 107 

97 Sacro-pubic Triangle, ... 108 

98 Coxo-pelvic Triangle, 109 

99 Lumbo-scrotal Triangle, 109 

100 Bourse of the Scrotum . .110 

101 Double T of the Trunk, Ill 

102 The Bavarian Plaster Splint, . 113 

103 Strapping for the Foot and Ankle, . . . . . .118 

104 Strapping for Superficial Cuts, 119 

105 Strapping for Deep Cuts, 119 

106 Strapping for a Testicle, 120 

107 Strapping for Extension of the Leg, . . . . . .122 

108 (a) The Surgeon's Knot, (b) The Reef Knot, . . . .123 

109 The Clove-hitch Knot, 124 

110 M. Gerdy's Extension Knot, . 125 



A MANUAL OF BANDAGING. 



CHAPTER I. 

CHARPIE — COTTON-WOOL. 

Of this there are four kinds : viz., raw, long, rasped and web-like. 
But one of these, the raw, is of moment. 

This is made by picking apart the threads of a piece of linen, 
each filament having a length from 2 to 3 inches \ if they are too 
short the filaments are apt to mat or lump together, and so render 
it unfit for the uses for which it was intended. A good article should 
be white, soft and light, and somewhat elastic. 

The difficulty of procuring a properly prepared charpie, and of' 
keeping it free from mattings has, at present, induced most surgeons 
to substitute for it clean cotton-wool. 

Charpie, or cotton-wool is used in surgery to protect from irrita- 
tion, to compress, and to slightly irritate, as well as to maintain in 
equal temperature a wounded member : one of its most common 
uses is, however, as an absorbent of the secretions from a wounded 
surface. For these multitudinous uses it is employed under the 
forms of plumasseaux, gateaux, boulettes, bourdonnets, tampons, pelotes, 
and layers or lamina. 

A Plumasseau (a pledget) — is but a bunch of charpie which 
has been drawn lengthwise lightly through the fingers till the fila- 
ments of the mass are made parallel with each other, and the mass 
made of the same thickness and density throughout. It may be used 
as an absorbent of secretion, for slight compression, or for carrying 
medicaments to a wounded surface. 

A Gateau (a cake) — is nothing more or less than a large 
plumasseau, with the ends of the charpie folded into the centre of 
3 



14 CBARPIE— COTTON- WOOL. 

the mass. Is used more especially for compression and for absorb- 
ing the secretions from a wound. 

A Boulette (a little ball) — is simply a ball of charpie formed 
by rolling little masses of it in the palms of the hands. They should 
be soft, elastic and loosely made. Are used for cleansing, or as 
carriers of sundry medicaments. 

A Bourdonnet (a dossil or lump of lint) — is a small plumas- 
seau tied closely around the middle, giving it an hour-glass shape. 
Used as a compress or as a slight tampon in cases of haemorrhage. 

Tampon (a plug) — is a large bourdonnet and prepared in the 
same manner as the preceding. Other forms and varieties are in 
use ; as the vaginal, rectal, etc. The two latter are perhaps prepared 
best from pieces of lint 3 or 4 inches square, soaked in water, then 
introduced singly, and "crowded closely home/' Sometimes, as in 
lithotomy, wounds of the rectum, etc., we wish to make strong 
lateral compression ; here use a tampon formed over a female (metal) 
catheter, by fastening the slotted end of the instrument securely to 
the center of a piece of lint 8 or 10 inches square ; introduce this 
into the wound, retaining the corners of the lint at the surface. 
When introduced, pack your charpie, or lint, or cotton-wool, closely 
around the shaft of the catheter, between it and the surrounding 
piece of lint, till you get the requisite amount of compression. This 
form of a tampon can be successfully used in these cases, as the lint 
(fastened to the catheter) prevents the escape of the charpie, or other 
packing substance, up the gut (in the case of rectal use), or beyond 
the point where pressure is desired to be made. 

A Pelote (a ball, or pin-cushion) — is formed by tying firmly a 
wisp of charpie in a piece of lint, giving it something the shape of an 
old-fashioned pin-cushion, as made over a broken lamp-stand. Uses ; 
bound over the course of an artery, it serves to arrest, for the time 
being, the flow of blood through it. It also serves the purpose of a 
tampon in certain cases of haemorrhage. 

Tents — have also been made of charpie by taking the long 
fibres of it, doubling in the middle, and then crowding it into the 
wound. But in our day of sponge tents, and the laminaria digitata, 



MANUAL OF BANDAGING. 15 

such a use of it will not be thought of save, in a case of emergency, 
when the manufactured tents are not at hand. 

The most of the above articles of dressing are now made from 
what is generally known as "surgeon's lint" (see Chapter II). 
Still, some surgeons prefer the charpie, or even oakum dressing, to 
any other. 



16 COMPRESSES. 



CHAPTER II. 

OF COMPRESSES. 

These are best made of the " surgeon's lint " cloth, it giving a 
more smooth, even and regular pressure. Their forms and sizes 
are almost innumerable, the surgeon using what the exigencies of 
the case may demand; yet the following brief classification may 
prove of service. We start with the most simple : 

The Square. — Its name indicates its peculiarity of form ; it 
may be of a rectangular piece of the " surgeon's lint," folded in the 
middle to make a square, thus being double thickness, or it may be 
built of a succession of smaller pieces to a pyramidal form, forming 
the graduated pyramidal compress. If each successive piece is of the 
same size as the first, it forms the graduated regular co??ipress. In 
either of the two latter forms, it should be stitched through and 
through, in two or three places, so as to prevent the pieces becoming 
displaced. 

Perhaps as simple a way of forming a graduated compress is the 
following : cut quite a long piece of the " lint " of the width of the 
compress desired, then placing one end of the fragment flatwise on 
the table to the extent of the size wanted in a longitudinal direction, 
fold it over upon itself, reversing the motion of the hand, till 
you reach the initial edge of the first layer ; here fold over again, re- 
versing the motion of the hand, and so on. Fig. i will give an idea 
fig. i. of the manoeuvres indicated, as the 

compress is seen on an exaggerated 
perpendicular section, a is the initial, 
b, the final end. In this case some 
stitches will be needed to confine the 
folds securely. 

The Triangular and Rectangular are but modifications of 
the above, and need no further description. 

The Circular is, as its name indicates, a circular piece of 
" surgeon's lint." We have three varieties of the circular compress : 
ist, the clipped; 2d, the perforated ; and 3d, the graduated. The first 




MANUAL OF BANDAGING. 17 

is the ordinary kind, the edges being clipped inwards to a sufficient 
extent that it may lie smoothly on a part. The second variety admits 
of any modification desirable in the position, form or extent of punc- 
ture or cut. The third is essentially formed in the same manner as 
the others of its class. 

The Complex. — Under this head all perforated and fenestrated 
compresses, and those of two or more heads, are meant to be in- 
cluded, whether they be rectangular or square. 

A Compress of Two Heads is simply a common compress 
with one end split at the centre as you see in Fig. 2. 

fig. 2. fig. 3. fig. 4. 




One of Three Heads. — A common compress with one end 
split into three equal or unequal parts, as seen in Fig. 3. 

A Sling Compress is a common compress having each end 
split at the middle, as seen in Fig. 4. It is also known as a compress 
of four heads. 

A Compress of Six Heads. — This is a compress similar to 
one of three heads ; the difference being that both ends are split into 
three equal or unequal parts. 

The Button-hole Compress is one that has two or more 
slits through its centre, as seen in Fig. 5. 

The Perforated Compress is one that has been, as its 
name implies, filled with small perforations, either by means of a 
stylet, or small punch, or by having pieces snipped out by the scis- 
sors. Fig. 6 will give you an idea of this. Is especially useful as a 
dressing for a freely suppurating surface. 



IS 



COMPBJESSES. 



FIG. 5. 



FIG. 6. 





The Uses of these various compresses are still more varied than 
their multiplicity of forms. The demands of the case must be met 
by the ingenuity of the surgeon in devising something appropriate ; 
and, having a knowledge of these more generally used forms, he can 
choose the one that will be most subservient to his purpose, or mo 
dify it to suit the exigencies of his case. 



MANUAL OF BANDAGING. 19 



CHAPTER III. 

ON BANDAGES IN GENERAL. 

Hippocrates has said that in bandaging there is a two-fold pur- 
pose to be kept in view ; viz. : " that which regards it while doing, 
and that which regards it when done. It should be done quickly 
without pain, with ease, and with elegance ; quickly, by dispatching 
the work ; without pain, by being readily done ; with ease, by being 
prepared for everything; and with elegance, so that it may be pleasing 
to the sight." 

There could, perhaps, be no more terse and comprehensive rules 
to be kept in mind as regards bandaging, than those offered by that 
great medical sage nearly twenty-five hundred years ago. And yet 
how often, in the drill our students receive in their class-rooms, has 
this exercise been deficient both in the teacher and in the taught. 
Yet, to the surgeon, a smoothly, rapidly applied bandage, aside from 
its extreme usefulness, has an element of beauty about it that is not 
readily forgotten. It begets confidence, too, in your patient, in his 
friends, and adds greatly to your professional reputation. Hippocrates 
appreciated this, and instructed his pupils thoroughly in the minutiae 
of the art. To-day it is almost wholly neglected, and even if spoken 
of at all, is dismissed as hurriedly as possible from the thoughts of 
faculty and students. 

Hippocrates further adds : " The form of the bandage should be 
suitable to the form and affection of the part to which it is applied. 
The force of the constriction should be such as to prevent the ad- 
joining parts from separating, without compressing them much, and 
so that the parts may be adjusted and not forced together." He 
further adds, after treating of the subject quite exhaustively, that "the 
bandages should be clean, light, soft and smooth. The heads of the 
bandages should be hard, smooth and neatly put on." This, coming 
from such antiquity, and agreeing with the hospital experiences of 
the last twenty-three hundred years should be enough to recommend 
it to your most earnest consideration. 



20 



BANDAGES IN GENERAL. 




The Maltese Cross. — This is formed from a square piece of 
surgeon's lint, by cutting up from each corner two-thirds of the way 
towards the centre of the piece, giving you when completed the form 
FIG - 7 - seen in Fig. 7. Another way of forming it 

is, to double the square piece of lint at its 
middle, then, transversely to this fold, double 
it over again ; this gives you four thicknesses 
of the lint. This done, cut diagonally across 
this small square, to a distance of two-thirds 
of the length of the diagonal, beginning at 
the four free corners of the folded lint. On 
unfolding, you will find you have a regularly and evenly made cross 
of this pattern. 

Uses.— Most generally employed in stump- and joint-dressings, 
as it readily adapts itself to all convex surfaces, the corners smoothly 
folding over each other, as it is applied. 

A Roller — is the term given to our common narrow bandage ; 
probably because to be used, it must first have been rolled 

smoothly and nicely up. Fig. 8 
shows you the bandage, or rol- 
ler, as ready for use. The part 
a is known as the head; the part 
b as the initial end. Figure 8 is 
therefore a roller with one head, 
and is classed as a simple bandage. 

Rollers may be of either one or two heads, at pleasure. In case 
of the latter the second head is formed by rolling up the initial end 
(b, in the cut) the same as the head a has been rolled. However, as a 
double-headed has no advantage over the single-headed roller, save in 
the bandage known as " the recurrent of the head," and a few others, 
I shall dismiss it, with but few exceptions, from the work. A single- 
headed roller is much more easily applied, looks just as well, and, in 
most cases, even answers the purpose better. 

Our single-headed roller has, then, besides the initial end and 
head, a plane, c ; an internal surf ace, c ; an external surf ace ; a superior 
and an inferior border. 




MANUAL OF BANDAGING. 21 

How to make a Roller. — Rollers are generally made of flan- 
nel. In some delicate operations where " heating " of the wound, or 
the contiguous surface, is feared, linen or cotton has taken its place. 
The two latter substances never apply so evenly or smoothly as the 
flannel, as there is little or no elasticity in them. On the contrary, 
both edges of a flannel roller will lie smoothly upon a part if proper- 
ly applied — a result difficult to be obtained on the use of a linen or 
cotton roller ; that is, if the surface be anywise irregular or uneven. 
Farther than this, the stimulus, from pressure to a part, that flannel 
often gives, through its quality of elasticity, is a great desideratum in 
most cases that require a bandage. Then, too, if the part should 
swell, the bandage gives ; if the swelling be reduced, the bandage, in 
great measure, accommodates itself to this change, " support " thus 
being continually kept up ; two other important qualities that are 
lacking in the linen or cotton roller. Of course the two latter have a 
plea of " cheapness," — of doubtful consideration, however, when the 
comfort (present and future) of the patient is at stake. 

The flannel having been torn into proper strips, as regards 
length and width, one end is taken and doubled over eight or ten 
inches upon itself ; this doubled portion again doubled upon itself, 
and this again upon itself, until it is in proper shape for "rolling," or 
winding. This is started by gently rolling the doubled portion be- 
tween the palm of the hand and table, or knee, as the case may be, 
until three or four turns are taken ; then the roll is grasped between 
the thumb and forefinger (the second finger assisting, if need be) of the 
left hand, the external surface (Fig. 8) of the bandage being up. The 
unwound portion is grasped by the right hand and allowed to fall in 
between the thumb and forefinger, as seen in Fig. 9. (Some surgeons 
fig. 9. prefer to have it fall in between 

I the first and second fingers, the 
thumb crowding in closely to the 
"head" of the bandage.) This 
(done, holding the bandage quite 
firmly, yet loosely enough to slip, 
between the thumb and finger, 
the thumb hugging tightly the 
head", by a downward or supine motion of the right hand, you 
4 




BANDAGES IN GENERAL. 



partially circle the forming roller-head, the ring-finger sliding over it 
as a guide. This done, grasp the roller-head firmly with the right 
hand (by pressing it against the ball of the thumb with the second 
and third ringers), pronate the hand as far as possible, then confide 
the grasp of the roller-head to the thumb and fingers of the left hand 
to go through with the same manoeuvres as before. In all of these 
motions the left hand is to be perfectly immovable, the right per- 
forming all the work, save the simple holding of the roller-head 
when the right is making its supination around it. Although beginning 
these motions slowly, you can soon increase their rapidity until you 
can " roll " a bandage with surprising quickness. As soon as the 
" catch" to it is mastered, it is easily and rapidly done. 

How to Apply a Roller. — To be applied easily it must be 
wound evenly and tightly. Hippocrates said, " the turns of a band- 
age should be made from right to left, and left to right, except on 
the head, where they should be in a straight or vertical direction." I 
would simplify this by allowing the surgeon to suit his own con- 
venience, remembering only to place the external surface of the ini- 
tial end to the part to be bandaged. This done, press it firmly with 
the fingers of the left hand to the member; the right hand grasps the 
roller-head tightly between the thumb and first and second fingers, 
and carries it firmly down and around the member (letting it slowly 
unwind) as far as possible ; then grasping it with the left hand, the 
thumb of the right confining the initial end, complete the turn, over- 
lapping the initial end completely or partially, as you see in turns i 
and 2 in Fig. 10. Make, then, one or two circular turns, as 3 and 
fig. 10. 4, firmly and evenly sweeping around the 

limb, each overlapping the preceding course 
about one-third the width of the bandage. 
"The reverses" which should always be made 
whenever the part to be bandaged assumes 
anything of a pyramidal or conoidal contour, 
as they keep the bandage from slipping down, 
are formed by pressing the first and second 
fingers firmly upon the superior border of the 
bandage at the point where the reverse is to 
be made, thus securing the bandage ; then, 
making a slack motion of the right hand, turn 




MANUAL OF BANDAGING. 23 

the bandage over end for end, by the right hand fingers, and bring 
what was the superior border of the bandage down to the top of the 
left hand's finger, or fingers that are confining the bandage ; you thus 
make, an inferior of what was the superior border. Each succeeding 
reverse is to be made in the same way. There is also a "catch" to this, 
although simple as it may seem, that only repeated trials will enable 
you to become master of. The main points, however, to bear in 
mind, are : ist. Keep the bandage always tight and with equal ten- 
sion at every turn. 2d. Bring it up somewhat diagonally, before 
making the reverse, and carry it down diagonally (the opposite of the 
other) after the reverse is made, as you see in the figure. 3d. Always 
have the edges of the overlapping turn as nearly equal all around 
as possible ; this is best done by keeping a " close eye " upon 
the upward and downward motions of the roller-head, and after a 
time this will be done unconsciously. The first few applications of 
a reversed roller should always be slowly and pains-takingly made, 
that your hands may not learn some bad tricks that must be un- 
learned them before they will apply one smoothly and nicely. Festina 
lente is a good motto in bandaging. 

How to Confine a Roller. — To confine a roller properly is a 
nice point in the application of such a surgical dressing, although it 
is a manoeuvre that is too often clumsily and imperfectly made. 

On reaching the terminal end of your bandage, always fold under 
the edges of the end, so as to bring it to the shape seen in Fig. n. 
no. 11. Then, introduce your pin {not per- 
pendicularly but) in a direction con- 
trary to the course of the bandage, 
as you see in the wood-cut. By so 
doing you will have it smoothly and 
securely confined. If the roller be very wide, two pins may be neces- 
sary. The " strain " on the bandage thus serves only to draw the 
pin into its place, and no ordinary amount of friction from the bed- 
clothes or wearing apparel will loosen it. 




24 CLASSIFICATION OF BANDAGES. 



CHAPTER IV. 

CLASSIFICATION OF BANDAGES. 

In olden times bandages received their names from four sources, 
viz. : i st. Their authors. 2d. Their forms. 3d. Their uses. 4th. 
From some fancied resemblance to some article, or manoeuvre. 

Thus we have the Hippocratic rhomb ; the crooked nose; the 
hare ; the quadriga, etc., as epidetic terms frequently to be met with 
on perusal of old authors. Nothing like a classification proper was 
attempted by them. Coming nearer to our own time an attempt was 
made to put them all under the heads of their uses ; such as " com- 
pressive," "retentive," "reductive," etc. But this utterly failed, as 
almost any bandage could be used for any of the special purposes 
for which the others were employed. Gerdy finally brought for- 
ward his system, that of referring all to some general figure, as 
"cross," "circular," "spiral," "figure of 8," etc., adding as a generic 
cognomen the part to which it was applied ; as " cross of the eye " ; 
" cross of the head" ; " spiral of the finger " ; " figure of eight of the 
chest," etc. Mayor then introduced his system of triangular and 
quadrilateral bandaging, naming them from the anatomical part to 
which they were applied ; a double name, in fact, the first being the 
part whereat the base of his triangle was applied, the other around 
or over which the ends were passed and fastened, e. g.; " occipito- 
frontal " would indicate that the base of his triangle was at the 
occiput, and the two ends of the triangle had been passed around 
and tied at the forehead. This latter system of nomenclature is 
really the more scientific ; but it is hardly convenient to adapt it to 
our roller bandaging, the system most universally employed. The 
system of triangles and quadrilaterals of Mayor, though very con- 
venient, will hardly come into general use, as it is impossible to get 
so smooth and nicely adjusted a triangle as a roller. In some cases, 
as for instance that of an exigency, it is well to understand his 
system ; as by that you can adapt almost anything to the purpose 
until a better dressing can be procured. 



MANUAL OF BANDAGING. 25 

All bandages are divisible into two great classes, the simple and 
the compound. Under each of these are found many varieties, the 
prominent ones of which will be given under their respective heads. 

A Simple Bandage is understood to be of a single strip of 
flannel, or cotton, and may have one or two heads ; may or may not 
be invaginated. In Mayor's system, a single triangle or quadri- 
lateral, invaginated or not, comes under this division. 

A Compound Bandage can be briefly defined as a bandage 
made up of two or more pieces of flannel or cotton, whether in 
strips (rollers), triangles, cravats, or quadrilaterals \ and may be in- 
vaginated, stitched (as a T)> or modified in any way that the surgeon 
may see fit. 

Besides these two general classes we have a regional classifica- 
tion ; merely, however, for descriptive convenience, as the execution 
of a bandage is essentially the same in all parts of the body. These 
divisions are ist. Bandages of the Head. 2d. Bandages of the Neck. 
3d. Bandages of the Upper Extremity. 4th. Bandages of the Trunk. 
5 th. Bandages of the Lower Extremity. 

This general plan of description we shall follow, giving first the 
roller bandages belonging to the simple order, following each one 
with Mayor's that fulfill the same office ; and lastly give those of the 
compound order, Mayor's triangles and cravats following those of 
Gerdy's system (the roller bandages), as before. 



26 BANDAGES OF THE HEAD. 



CHAPTER V. 

BANDAGES OF THE HEAD. 

SKULL-CAP. 

In all of the bandages of the head it is well to first apply a close- 
fitting flannel or cotton cap, known as a skull-cap, to the head. It 
retains the bandage better in position, as it keeps the turns from 
coming in contact with the slippery and sliding hair. It will also be 
found full as comfortable to the patient, as it tends to keep the 
hair evenly distributed about the head, and so prevents its matting 
under different portions of the bandage. Pressure from the band- 
age is also more equable. 

CIECULAK OF THE FOREHEAD AND EYES. 

Description. — It should be three or four yards in length and 
have a width of from one and one-half to two inches. 

Application. — Place the initial end i at or near the centre of 

fig. 12. the forehead, standing at the back of 

the patient, and confine by a horizontal 
circular turn, 2. At the 3d turn begin to 
drop the course of the bandage still 
more, so that on its completion it shall 
have been dropped one-half or three- 
quarters of its width. The 4th turn is 
to be made in a similar manner, cover- 
lar of the Forehead and Eyes ing the eyes and as much of the face 
as seems necessary ; then, after an upward spiral course, 5, confine 
the bandage by a pin or thread, at or near its starting point. 

Uses.— This bandage, though necessarily so simple, fulfills 
many important indications. In wounds of the forehead or upper 
part of the face, and operations thereon, in injuries and operations 




MANUAL OF BANDAGING. 27 

of the eyes and nose, and nasal passages, it serves to convey proper 
soothing applications to the parts, as well as to restrain excessive 
muscular action, and so facilitates union between the edges of the 
wound. 



THE FILLET OR HEAD-BAND. 

Description. — A piece of flannel, or cotton, thirty inches long 
by twelve inches wide. At a half an inch from the inferior border, 
midway from the two ends of the bandage, cut out a triangular piece 
(the base downwards) so as to leave an opening sufficiently large to 
admit the nose. 

Application. — Standing behind your patient, place the centre 
fig. 13. of the bandage over the face, covering 

it from the mouth up ; the nose being 
permitted to pass through the triangu- 
lar opening. Carry each end horizon- 
tally backwards about the head, and 
confine with pins or stitches. 

Uses. — This bandage admirably 
takes the place of the preceding in 
retaining dressings to the parts about 
the upper portion of the face. It can 
be used (though it is less elegant) in 
the place of the Monocle or Binocle, 

The Fillet or Head-band. SOOn to be treated of. 

A " Sling" and a " Triangle" of the face have been devised, but 
are really not so convenient as the Fillet. The former is a four-tailed 
bandage (made similarly as the Sling Compress, Fig. 4, page 17). 
The body of the bandage is placed over the face, and the extremities 
are carried backwards and fastened, the two superior at the nape of 
the neck ; the two inferior above the occiput ; or, they may be crossed 
at these points and brought forward, and finally confined in front. 
The Facial Triangle is applied in a similar manner. It should be, the 
base of the triangle, one yard in length ; the height, that is from the 
base to the apex, should be eighteen inches. 




28 



BANDAGES OF THE HEAD. 



CKOSS OF THE EYE. 



(Monocle.) 

Description. — This bandage should be six yards in length and 
have a width of from one and a half to two inches. 

Application. — Taking the right eye, for example, standing be- 
hind your patient, place the initial end 
of the roller, i, above the right eye> 
previously protected by a compress or 
some cotton-wool. Confine this by one 
horizontal circular turn, 2, about the 
head and continue on till you come to 
the occiput, for the next turn; here 
you make a pass downwards, coming 
along under the right ear, then up over 
the inferior angle of the inferior maxilla 
of the right side, and across the inner 
angle of the orbit, finishing the third 
cross of the Eye. course of the bandage. Continuing on 

from this point (the forehead), the bandage is to be carried up over 
the left parietal protuberance, then down to a level with the circular 
turns 1 and 2, and finally finished as a circular of the head, thus 
making the fourth course. Course 5 is to be executed the same as 
course 3, remembering to overlap in its course, to the distance of 
one-half or three-quarters of its width, the preceding turn. Course 
6 is executed the same as course 4, remembering the overlapping. 
Finally, when you come near the terminal end of your bandage, con- 
fine by one or two circular turns about the forehead and occiput, 
following courses 1 and 2. 

Uses. — This is a very pretty and firm monocular bandage when 
evenly applied ; yet it is one that needs some watching lest some of 
the courses overslip each other, especially if put on a patient that is 
not very quiet. A light compress or cotton-wool should fill up the 




MANUAL OF BANDAGING. 29 

orbital cavity, thus not only keeping the lids securely closed, but it 
will steady the eye-ball in its socket, as well as produce slight com- 
pression. 

In the case of the left eye, the proceeding is the same, reversing 
only the direction of the courses. 

For The Triangle of the £ye, see " Uses " under the bandage 
Fronto-oculo-occipital Triangle, page 30. 



CEOSS OF THE EYES. 

(Binode.) 

Description. — This bandage should be eight yards in length 
and have a width of from one and a half to two inches. 

Application. — Standing behind your patient, place the initial 
fig. 15. end of the bandage, 1, over his right 

eyebrow, and confine there by a hori- 
zontal circular turn about the head, 2. 
On the third turn, when coming to the 
occiput, pass the bandage down so as to 
come around under the right ear, up over 
the inferior angle of the lower maxilla, 
and up over the inner angle of the orbit 
of the right side, thus finishing the third 
course of the bandage. From this point 
carry the bandage up over the left parie- 
Cross of the Eyes. " tal eminence, then down to the occiput, 

and finally horizontally about the head, thus finishing course 4. 
Continue the course of the bandage horizontally about the head un- 
til you come to the occipital region, when you mount up over the 
right parietal eminence, and pass downwards over the inner canthus 
of the left eye, thus finishing the fifth course of the bandage. Con- 
tinue the bandage down across the left cheek and maxilla, and back 
under the left ear to the occiput, where you mount up to the level of 
courses 1 and 2, when you finish course 6 as a horizontal turn about 
the head. 

5 




30 BANDAGES OF THE HEAD. 

Turns 7, 8 and 9 are done the same as Nos. 3, 4 and 5, 
respectively, remembering always to draw in the bandage, by over- 
lapping its underlying fellow by one-fourth, or one-third its width. 

On the completion of its application to the eyes, confine by a 
single horizontal turn about the forehead and occiput, fastening with 
a pin. 

Uses. — This bandage fulfils the same indications for both eyes 
that the preceding does for the one eye. The " double-headed " 
roller, for the same purpose, I have omitted, as it is not so firm a 
bandage, and is more complicated. The ears and parietal protu- 
berances are the main points of support to these ocular bandages ; 
hence pay particular attention to the "laying of the bandage" about 
these parts. 



FKONTO-OCULO-OCCIPITAL TRIANGLE. 

( 'Head-band of Mayor 's System.) 

Description. — Take a piece of cotton-cloth large enough so 
that when folded to a triangle, the base of the triangle will measure 
one yard, while its height (from apex to centre of base) will be from 
fifteen to twenty inches. 

Application. — Standing behind the patient, place the base of 

fig. 16. the triangle over the eyes, having the apex 

over the head, pointing to the occiput. 

Carry both ends of the base horizontally 

around to the occiput, covering over the 

apex of the bandage, and cross there, 

bring them forwards and confine at the 

forehead, a, a, either by pinning or 

tying. Lastly, carry the apex from the 

occiput up over the horizontal courses of 

the two extremities to the region of the 
Fronto-Oculo-Occipital Triangle x , j 1 r •', 

torehead, and confine with a pin, as at b. 

Uses. -This is a very simple bandage, as indeed all of Mayor's 
are, and will nicely take the place of the preceding Cross of the 




MANUAL OF BANDAGING. 31 

Eyes, or Binocle. It can be easily tilted to one side, covering in 
only one eye. so as to fulfil the condition of the monocular cross, 
plated on page 28. It is not so firm, or evenly compressing a 
bandage, as the two preceding, and hence would not be so appli- 
cable after an operation for cataract, or an iridectomy. Of course 
cotton-wool, or some light dressing, will need to be applied to the 
ocular fossaj before the application of this triangle, just as in the 
Crosses of the eyes. 



FRONTO OCCIPITAL TRIANGLE. 

(Triangular Bonnet of the Head.) 

Description. — This bandage should measure one yard or more 
from end to end, across the base, and should have a height of fifteen 
or twenty inches. 

Application. — Standing behind the patient, place the base of 
fig. 17. the triangle, 1, at the forehead, over 

the eyes, having the apex at the occiput. 
Carry the two extremities horizontally 
backwards to the occiput, covering in 
the apex, cross them there, and then 
bring them forwards and confine at the 
forehead, 2. Finally bring the apex 
forwards and confine, as at b. 

Fronto-occipitai Triangle. Modifications.— I. By reversing 

the application of this bandage, putting the base at the occiput and 
the apex at the forehead, you get the Orcipito-frontal Triangle of 
Mayor. 

II. By placing the base at one of the sides of the head, the apex 
covering the other, you get Mayor's Biparietal Triangle. 

Uses.— -The uses of these triangles are very numerous, as they 
are applicable for maintaining any dressing to almost any p art ofthe 
head. In so doing they take the place, in great measure, of the 
Recurrent of the Head, and the Six-Tailed Bandage of the Head 
to be described further on. 




32 



BANDAGES OF THE BEAD 



SIMPLE CROSS OF THE CHIN. 

(Roller Bandage of the Chin.) 

Description. — This bandage should be about nine yards in 
length, and have a width of one and one-half inches. 

Application. — Standing at your patient's back, place the initial 
fig. 18. end of the bandage, i, over the 

left eyebrow, and confine by one 
single, horizontal, circular turn, 2, 
bringing the bandage down under 
the right ear, continuing it under 
the lower maxilla and up over the 
left maxillary ramus, and ear, fin- 
ishing turn 3. Make, for turns 4 
and 5, two vertical circular passes 
in the course of turn 3, gradually 
working towards the symphysis of 
the lower jaw, by overlapping each 
preceding turn one-half or one- 
After turn 5 has been brought to 
the right inferior angle of the lower jaw, make a single horizontal 
circle of the neck, 6. At the back part of the neck mount up the 
occiput, so as to make the fronto-occipital horizontal turn 7. Then 
continue on to the occiput, down below the right ear, across the 
symphysis of the chin, making turn 8. Circle the chin again, hori- 
zontally (turn 9), then mount to the top of the head, passing under 
the lower jaw, forming turn 10, which is still anterior to turn 5. Turn 
n is made in the course of turn 10, overlapping it in its course. 
Bring the bandage down under the lower jaw again, thence circle the 
neck horizontally, forming turn 12. Finally, mount to the forehead 
from the occipital region, and confine your bandage by a horizontal 
circular turn, as 13. 

Uses. — In cases of fractures or dislocation of the lower jaw. It 
is also of use in confining any topical application to the chin, to the 
parotid regions, and to the ears. 




Simple Cross of the Chin. 

fourth the width of the bandage. 



I 



MANUAL OF BANDAGING. 33 

Care should be had that too much constriction is not put upon 
the neck in making turns 6 and 12, thereby hindering respiration 
and circulation. If a flannel roller is used no allowance need be 
made for the swelling of the parts, as the bandage will generally give 
enough, if it is only "comfortably" (to the patient) applied at first. 



fig. 19. 



FOUR-TAILED BANDAGE OF THE CHIN. 

(S/ing of the Chin.) 
Description. — This bandage should be one and one-fourth yards 
in length, and have a width of about five 
inches. It should be torn, at the middle 
of each end, towards the centre (as you 
see in Fig. 4, page 17) to within two and 
one-half inches of this point. 

Application. — Standing at the back 
of your patient, place the centre of the 
plane of the bandage, 1, at the chin ; then 
carry the two superior ends of your band- 
age backwards, below the ears, to the 
nape of the neck ; crossing them here, 
sung of the chin. bring them upwar d s a nd forwards over 

the parietal protuberances, and confine at the forehead, 2. Take 
now the two inferior ends of the bandage, carry them backwards 
and obliquely upwards across the temporo-maxillary articulations, 
and confine at the superior posterior angles of the parietal bones, 3. 

Uses. — This is quite a firm and solid bandage, and very easy of 
application. It does not, however, give that full support to the parts 
as the preceding, yet it is very applicable when the mobility of the 
parts is not over-increased by a very oblique or double fracture, or 
by extensive luxations of the inferior maxilla. For the maintaining 
of dressings to the chin, parotid region, and the ear, it is, from its 
simplicity, much to be preferred to the Simple Cross of the Chin. 




34 BANJJAGES OF THE HEAD. 

OCCIPITOMENTAL TRIANGLE. 

(Mayors Triangle of the Chin.) 

Description. — Have your triangle with a base full one and 
one-half yards in length, and with a height of twenty inches, or 
more. 

Application. — Standing behind your patient, place the base of 

fj g- 20. the triangle, a, the apex looking 

backwards, at the top of the head ; 
seize the two ends of the triangle 
and bring one down below, and the 
other over and in front of the chin, 
crossing them this way, b, b, and 
then carry them obliquely backwards 
and upwards across the temporal 
and mastoid regions to confine them 
at the summit of the occiput. Con- 
fine the apex as at d. 

Occipito-Mentai Triangle. Uses. — This bandage was de- 

signed by Mayor to take the place of the two preceding bandages 
this it does, in a measure, in its ready applicability for the confine- 
ment of dressings about the regions it covers. It is easily extem- 
porized, and hence is a " popular " way for maintaining topical ap- 
plications to these parts. 

All of the more modern appliances for the treatment of fractures 
of the inferior maxilla are but modifications of the three bandages 
just given. A paste-board, or felt splint, with these bandages, 
will probably fulfil any of the indications that these more 
elaborate appliances are designed to, and are full as comfortable to 
your patient. 

CROSS OF THE HEAD. 
(Temple Bandage.) 

Description. — This bandage should be two inches in width by 
six or seven yards in length. 




MANUAL OF BANDAGFXG. 



35 




Application. — Standing behind your patient, place the initial 
rJG - 21. end of the bandage, i, over the right 

eye, and confine it by a circular turn, 
2, about the head. Continue on for a 
third course until you come to the 
right ear; here confine the bandage 
either by stitches, or a pin, inserted 
perpendicularly to the preceding cour- 
ses of the bandage. This done, de- 
scend perpendicularly with the roller- 
head to the posterior angle of the 
inferior maxilla, covering over the right 
ear, and, passing under the lower jaw, 
continue the bandage up over the left 
Cross of the Head. ear to t h e top of the head ; then de- 

scend to the horizontal courses of the bandage, thus completing 
course 4. Turns 5, 6, 7 and 8 are to follow in the course of turn 
4, viz., perpendicularly around the head, remembering to bring the 
bandage gradually forwards by overlapping each preceding turn the 
quarter, or half, the width of the bandage. Turn 8 being brought 
to the level of the horizontal turn 2, upon the right side, it is to be 
fastened with stitches, or a pin, perpendicularly to the course of 
turns 6, 7 and 8, the remaining bandage being exhausted by hori- 
zontal turns about the head and occiput, in the course of turns 
1 and 2. 

In this application of The Cross of the Head, it has been 
supposed that it was the right ear, temple, or parotid region that was 
diseased, or injured. In case of the left, you have but to reverse 
the application of the bandage ; that is, make your turns from left 
to right, across the forehead, putting the initial end over the left eye. 

Uses. — For protection of, or application of dressings to, the 
ears, temples, parotid or hyoid regions. Is readily applied and 
makes a firm dressing. 



36 



BANDAGES OF THE HEAD. 



KNOTTED BANDAGE OF THE HEAD. 
Description. — This bandage should be one and a half inches 
in width and eight or ten yards in length, and rolled into two heads. 

Application. — Place the plane of the bandage over the injured 
fig. 22. temple (the left, for example) and then 

carry the two heads horizontally about 
the head to the right parietal region, 
where you cross one over the other ; 
continue them on till you come to the 
starting point, thus finishing course 2. 
Crossing them here at right angles 
(that is, upon the diseased temple), 
carry one head of the bandage perpen- 
dicularly over the head, while you carry 

the other perpendicularly downwards 
Knotted Bandage of the Head. under ^ ^,3, ^ continuing ^ 

course of each around the head and chin, until they meet at the 
diseased temple again, thus finishing the third course. Cross them 
at right angles again at this point, continuing horizontally about the 
head, as in course 1, until you come to the diseased temple again, 
thus finishing turn 4. Turn 5 is formed the same as was turn 3, and 
turn 6, as turn 4, etc., etc. ; at last confine the ends of the bandage 
in the ordinary way. 

Uses. — This bandage is intended to exercise pressure upon 
the temporal artery, as in case of wounds, accidental or otherwise. 
It needs to be applied with care, and to be watched, as it is possible 
to make the compression too severe for a long-continued application 
of the bandage, It should always be aided by a Graduated Pyrami- 
dal Compress (see page 16). 




THE T OF THE HEAD AND EAE. 

(T of the Temple.) 

Description. — Take first a bandage from two to four inches wide 

(according to the extent of the injury to the side of the head) and 

one yard in length ; at right angles to this bandage, at a distance of 




MANUAL OF BANDAGING. 37 

ten or twelve inches from one end, there should be stitched another 
bandage two inches wide and two and a half yards in length, leaving 
one of its ends projecting some sixteen or eighteen inches beyond 
the first or widest portion. 

Application. — Place the point of juncture of the two bandages, 
fig. 23. a, over the right temporal re- 

gion, if this be the one involved, 
in such a manner that the widest 
portion of the bandage, b, shall 
be perpendicular, as regards the 
head \ then carry the long end 
of this wide portion of the band- 
age, b, down under the chin, 
and up on the other side to the 
top of the head, there tying or 
pinning it to the short end, 
brought perpendicularly up- 
wards from the diseased tem- 
poral region. The longer and 
narrower portion of the bandage, a, is now to be carried horizon, 
tally about the head, the long end confining the short one by suc- 
cessive horizontal courses till it is exhausted, when confine in the 
usual manner. 

Uses. — For confining dressings to the temporal, parotid and 
hyoid regions. 

PERFORATED T OF THE HEAD AND EAR. 

Description. — The first piece should be three yards long by two 
inches wide, and to this, perpendicular to its plane, there should be 
stitched, at eighteen inches from one of its ends, a bandage having 
the same length and width, save at the extremity attached to the 
first piece ; here it should be semi-oval, with a width two or three 
times that of the plane of the bandage ; this oval part should be per- 
forated by a longitudinal slit of sufficient size to " take in " the ear. 

Application. — Pass the ear of the diseased side (suppose it to 
be the right) through the second portion of the bandage, b, bringing 
6 



The T of the Head and Ear. 



38 



BANDAGES OF THE HEAD. 



fig. 24. the bandage closely and snug- 

ly up to the head. Carry the 
shorter end of the horizontal 
portion of the bandage smooth- 
ly around the occiput and 
forehead, and confine by a 
single horizontal circular turn, 
2. Carry, now, the perpen- 
dicular portion of the band- 
age, b, down under the chin, 
up over the opposite ear to 
the top of the head, and down 
to the starting point, thus 
finishing the first turn of the 
perpendicular portion of the bandage. Exhaust the remaining 
portion of the bandage, b', by similar perpendicular turns about the 
head, and at last confine the end, by a pin, to the horizontal turn 
2. This done, exhaust the remaining portion of the roller, a, by 
horizontal turns about the head, confining as usual. 

Uses. — This bandage is found very useful in maintaining blis- 
ters to the mastoid process, or dressings thereto, as is frequently 
needed in diseases of the ears. It is equally useful in confining 
dressings upon the ears, temporal, parotid, and tonsillar regions. 




Perforated T of the Head and Ear. 



OCCIPITO-AURICULAR TRIANGLE. 

(Mayor's Cross of the Head.) 

Description. — This should be a triangle having a base of one 
yard in length, and a height of some eighteen inches. 

Application. — This is essentially the same as that of the Occi- 
pito-mental Triangle (page 34). The only difference being that this 
one is crossed below, instead of upon, the chin. 

Uses. — Essentially the same as many of those for which The 
Knotted Bandage of the Head (page 36), The f of the Head and 
Ear (page 37), and The Perforated X °f tne Head and Ear (page 
38) are employed. 



MANUAL OF BANDAGING. 



:5v* 




Recurrent Bandage of the Head. 



RECURRENT BANDAGE OF THE HEAD. 

(Roller Cap of the Head.) 

Description.— This should be one and one-half or two inches 
in width, and about nine yards in length. It should be rolled into 
two heads, one being a little larger than the other. 

Application. — Standing at the back of your patient, place the 
fig. 25. plane of the bandage above 

the eyebrows, carrying each 
roller head backwards above 
the ears to the occiput ; cros- 
sing them there at right angles, 
carry the inferior portion up 
over the top of the head, in 
line of the saggital suture, 2, 
to the forehead ; this is called 
the "recurrent" portion. Now 
carry horizontally forwards the 
other roller-head, crossing over the recurrent portion (thus binding it 
down) at the left frontal region, thus finishing the horizontal turn 2'. 
Carry now the recurrent roller-head up over the horizontal turn 2' 
and the right parietal eminence down to the occiput, thus finishing 
the turn 3. Conduct the other roller-head again horizontally about 
the head, binding down the course 3 at the occiput, and finish it as 
turn 3' at the forehead. Courses 4, 6, 8 and 10 are made similar to 
course 2, whilst courses 5, 7 and 9 are formed similarly as course 3. 
The horizontal courses 4', 5', '6 and 7' are formed similarly as their 
preceding courses, 2' and 3', each binding down some one course of 
the recurrent portions of the bandage, — the turns 4, 5, 6, 7, 8, 9 and 
10, running from the forehead to the occiput. 

Uses. — This is not a very useful bandage, though it looks very 
nicely when properly applied. The objection to it is, that to give it 
the proper degree of firmness and security, one has to draw the con. 
fining turns of the bandage quite tightly ; and this, from the repeti- 
tion of these turns so directly above the others, gives to the patient 
an uncomfortable feeling of tightness and constriction about the 



40 



BANDAGES OF THE READ. 



head. Besides this, if the wound is very large, it will press upon the 
bruised portions, and so cause excessive pain, and venous obstruc- 
tion. In scalp wounds of the top of the head it might be used to 
good advantage. 



fig. 26. 




SIX-TAILED BANDAGE OF THE HEAD. 

(Sling of the Head.) 

Description. — This bandage should be forty inches in length, 
by fifteen in width. Double it, lengthwise ; at the middle ; then, at a 
point (upon each side) three inches from the lateral border, i, cut 
directly toward the folded centre till you come 
to within three or four inches of it, 2. Then 
cut obliquely toward the same point, repre- 
sented by the line 3-2 in the cut, thus remov- 
ing the triangular pieces 1-2-3 an d 3-2-1. 
The portion 3-3 should be three inches in 
width. 

Application. — Place the plane of the 
bandage upon the top of the head, the ends 
Bring the central ends, a, a', directly down 
under the chin, and there 
confine by tying. Carry then 
the two front ends, b, b', 
horizontally backwards, and 
confine at the occiput. This 
done, bring the two posterior 
ends, c, 'c, horizontally for- 
wards, and confine at the 
forehead. 



Uses. — This bandage is 
applicable for dressing any 
injury of the top or sides of 
the head. As it is simple, 
easily applied, and readily 



Diagram. 

being at the sides. 

fig. 27 




Six-tailed Bandage of the Head. 



MANUAL OF BANDAGING. 41 

maintains its position, it may be preferred to the preceding and 
following. The suggestion that Galen makes (for it is known as his 
bandage) is a good one. It is to split the two middle ends, so as to 
allow the passage of the ears in cases where the condition of the 
patient will warrant such exposure. 



TRIANGLE OF THE HEAD. 

(Handkerchief Bandage. ) 

Description. — This bandage should be a piece of linen, or a 
handkerchief, twenty-four to thirty inches square. Fold it to a 
triangle. 

Application. — Standing behind your patient, place the bandage 
fig. 28. over the top of the head, the triangu- 

lar portion hanging down over the 
face. Carry the two ends a, a' for- 
wards to the forehead, there crossing 
them so as to carry them back, 2, 2, 
to the occiput, to be confined by 
tying or pinning. Then seize the 
triangular portion that hangs in front 
of the face, and carry it directly up- 
wards and fold it under the horizontal 

Triangle of the Head. turns of A, a', as at C. 

Uses. — As it is easily applied, and the material always at hand, 
it makes an excellent temporary bandage in cases of wounds or in- 
juries of the upper portion of the head. It is not, however, quite so 
firm a dressing as the bandage just described. 



DOUBLE T OF THE NOSE. 
Description. — A strip of flannel, two and one-half yards long 
by one inch wide. At the central portion of this, at a distance of 
one inch from each other, there are to be stitched, at right angles 
with the first piece, two other strips, each thirty inches in length by 
three-quarters of an inch in width. 




42 



BANDAGES OF THE HEAD. 




Application. — Standing behind your patient, place the plane 

of the main bandage (rolled into 
two heads) beneath the nose, a, and 
so that the other two portions, b', 
b, may pass up, one upon each 
side, along the nose. Carry the 
heads of the main bandage, a, hori- 
zontally backwards to the occiput, 
and cross one head above the other; 
then take the two perpendicular 
portions of the bandage, b', b, up 
over the top of the head, having 

them cross each other at the root of 
Double T of the Nose. ., ., . ,, . , , .., 

the nose, so that the right will pass 

over the left parietal region, the left over the right parietal region, 

and continue their courses down to the neck, passing one of them 

beneath the crossed courses of the main part, a ; then carry the two 

roller-heads a a', obliquely upwards across the forehead, and confine 

with pins, etc., after exhausting both by horizontal turns about the 

forehead and occiput. This done, tie the ends of the portions b', b, 

about the first turn of the roller-heads of the portion a, at the nape 

of the neck. 

Uses. — To maintain dressings to the parts about the nose, as in 
cases of injury, or after a rhinoplastic operation; or, to hold 
coapted the nasal bones, when fractured. 



T OF THE MOUTH. 
Description. — This bandage should be, the main piece, two 
yards long and two inches wide. At twenty-four inches from the 
initial end of this piece there should be stitched (at right-angles) to 
the superior border, a second strip, two feet in length by two inches 
in width. Cut out a triangular piece, large enough for the passage of 
the nose, from this second bandage at the place where it is joined 
to the main roller. Also, from the main roller, at a point below the 
triangular opening for the nose, cut out a sufficiently large, oval sec- 
tion to accommodate the mouth and lips. 



MANUAL OF BANDAGING. 43 

Application. — Standing behind your patient, place the plane 
fig. 30. of the bandage across the face, so that 

the oval aperture will correspond to 
the mouth, and the triangular to the 
nose ; carry the two ends of the main 
bandage, a, a', backwards under the 
ears to the nape of the neck, and cross 
them, one above the other, there. Then 
conduct the perpendicular portion of 
the bandage, b, up between the eyes, 
over the summit of the head, down to 
the crossed ends of the part a, a', and 
T of the Mouth. either confine there by pins or stitches; 

or, after passing under and then over the crossed courses of the 
main bandage, remount the head and confine at or near the fore- 
head. This done, carry the ends of the main bandage forwards over 
the ears and exhaust them by horizontal turns about the forehead 
and occiput, as at a 2, the shorter extremity being first applied. 

Uses. — For confining dressings about the mouth, jaws, cheeks, 
or for maintaining the parts in apposition after plasting operations, or 
other surgical procedures. This, and the preceding bandage, are 
especially applicable in cases of transverse wounds of the lip at the 
nasal alae, or frsenum. 




INVAGINATED ROLLER OF THE UPPER LIP. 

(Hare-lip Bandage.) 

Description. — I. A two-headed roller, three yards long by 
three-quarters of an inch wide. 

II. A long narrow compress, say one and one-fourth yards in 
length by two inches in width. 

III. A graduated pyramidal compress, two inches in length, one 
and one-half inches in width, and one inch in thickness. The folds 
of the compress should be stitched through and through, at each 
end, in order to prevent their slipping. 




44 BANDAGES OF THE HEAD. 

Application.— Place the graduated compresses a, a', one upon 

FIG - 31 - each side, in the hollow of the cheeks, 

below the zygoma, and at about one inch 
distance from either angle of the mouth, 
pressing the cheeks and lips well forwards 
towards the median line. Delivering them 
to the care of an assistant, take the long 
compress, b, and place its middle over the 
summit of the head, allowing the ends to 
hang down over the sides of the face, and 
to cover in the graduated compresses, the 
patient finally holding the ends together 
under the chin. This done, place the 
mvaginated Roller of the Upper P lane of the double-headed roller, i, upon 
Lip- the forehead, standing behind your pa- 

tient, and carry the heads backwards and downwards to the nape 
of the neck, here crossing them to carry them horizontally forwards 
to the superior lip, 2, 2', passing one through a slit in the other. 
Then carry them horizontally backwards to the neck, crossing them 
again at that point, to carry them forwards to the lip again, passing 
one through the other, as before, thus finishing turn 3, 3', consigning 
the heads to an assistant. Take, now, the two ends of the long com- 
press that has been confined temporarily, by the patient, and fold 
each upwards over the circular turns of the roller, and confine with 
pins at the temple or top of the head. This done, take the roller- 
heads, carry them horizontally backwards (over the folded com- 
press) to the nape of the neck, recrossing them to mount up to the 
forehead, and exhaust there by horizontal circular turns. 

Uses. — Useful in all wounds of the lips for keeping the parts 
eoapted ; in operations for cure of " hare-lip " where the tissue seems 
to be scanty, and the lip-wounds are hard to bring together, it is 
especially applicable. 

Variety.— This bandage can be made equally available for 
wounds of the lower lip. It is then to be known as the Invaginated 
Roller of the Under Lip. The only difference in the application 
being that the pyramidal compresses, a, a', shall be dropped lower, 
and that the crosses of the bandage 2, 2', and 3, 3', shall take place 
upon the labium inferius. 



i 




MANUAL OF BANDAGING. 45 

FRONTO-CERVICO-LABIAL TRIANGLE. 

(Mayor's Invaginated Bandage of the Upper Lip.) 
Description. — A square should be folded to a triangle, having 
a base of forty inches, and a height of eighteen inches. 

Application. — Place the centre of the base of the triangle upon 
fig. 32. the forehead, a, carrying the extremities 

down and backwards to the nape of the 
neck, covering over the apex of the tri- 
angle, there crossing them; then bring 
them forward over the upper lip, putting 
one extremity through a slit in the other, 
as 2, 2'. Carry the ends horizontally back- 
wards to the nape of the neck, there con- 
fining them by tying, or otherwise. The 
apex of the triangle is to be carried direct- 
ly up over the occiput and pinned at the 
Fronto-Cervico-Labial Triangle. 

summit of the head, as at 3. Compresses 

similar to those used in the preceding can be employed to advantage 
in this bandage of Mayor's ; and they are especially indicated if 
much tendency to gaping exists in the wound. 

Uses. — The same as those of the preceding. As it is more 
easily applied, and quite as serviceable, it might be recommended, 
in most cases, to take the place of the Roller Invaginated for the 
Upper Lip. 

Variety. — Instead of crossing the extremities of the triangle 
upon the upper lip, they can be made to cross upon the under one, 
and thus fulfil the indications of The Roller Invaginated of the 
Under Lip, described upon page 44. It is then known as The 
Invaginated Triangle of the Under Lip. 

POSTERIOR CROSS OF THE HEAD AND NECK. 

(Cross of the Occiput.) 
'' Description. — This bandage should be five yards in length, 
and one and one-half inches in width. 

7 




46 BANDAGES OF THE HEAD. 

Application. — Standing at your patient's back, place the initial 
fig. 33. end of the bandage near the occiput, as at 

i, and confine it by a single horizontal 
turn, 2 ; afterwards carry it round to the 
forehead, in the course of turn 2, till you 
come to the left parietal protuberance, 
when you carry it diagonally down to the 
nape of the neck, finishing course 3 ; con- 
tinue onwards around the neck, making 
a horizontal circular turn about it for 
course 4. For course 5, carry the roller- 
head obliquely up across the occiput, over 
the right ear, then obliquely down to the 
Posterior Cross of the Head and nape of the neck, from over the left ear, 
thus finishing course 6. Course 7 is the 

same as course 5. Course 8, the same as course 6, and so on ; at 

last finish by horizontal turns, about the forehead and occiput, and 

confine with pins as usual. 

Uses. — In confining rubefacients and vesicants to the nape of 

the neck ; also, for retaining dressings, or emollient applications, to 

burns and other injuries about the occipital region. 



FOUK-TAILED BANDAGE OF THE HEAD AND NECK. 
(Sling of the Occiput.) 

Description. — This should be forty-eight inches in length by 
five inches in width. Fold it lengthwise at the centre, and cut back 
the ends, in the median line, to within three or four inches of the 
fold. 

Application. — Place the plane of the bandage at the nape of 
the neck ; carry the superior ends of the bandage up over the head 
and confine there by tying. Then carry the inferior ends horizontal- 
ly forwards around the neck, and tie ; or else cross them, and return 
to the back of the neck with them, and there pin. 

Uses. — Similar to that of the Posterior Cross of the Head and 
Neck, described above. 



MANUAL OF BANDAGING. 47 



CHAPTER VI. 

BANDAGES OF THE NECK. 

' CIRCULAR OF THE NECK. 

(Spiral of the Neck.) 

Description. — This bandage should be one yard in length and 
one and a half inches in width. 

Application. — Place the initial end of the bandage at one side 
of the neck, quite low down, and exhaust it by circular turns, gradu- 
ally working upwards to the jaw, so as to give a spiral form to the 
courses of the bandage. Confine in the usual way. 

Uses. — Is useful in maintaining dressings to the back, sides, or 
front of the neck. Caution should be observed that it does not con- 
strict the parts, and so impede circulation. 



CERVICAL CRAVAT. 

Description. — A triangle folded to a cravat of sufficient length 
to encircle the neck twice. 

Application. — Place the middle of the cravat over or near the 
seat of injury, carry the ends horizontally backward, cross them and 
bring forwards again, and confine by tying. 

Uses. — Similar to the Circular of the Neck ; as it is much 
simpler, probably this bandage of Mayor will be more often used 
than the preceding. 



POSTERIOR FIGURE OF 8 OF THE HEAD AND THE AXILLA. 

Description. — This bandage should be nine yards long by 
one and three-quarter inches wide. 



48 



BANDAGES OF THE NECK. 




Posterior Figure of 8 of the Head and the 
Axillae. 



Application. —Standing at the back of your patient, place the 

initial end of the bandage at 
the occiput, i, and confine by 
a horizontal turn, 2, about the 
head. Bend, now, the patient's 
head backwards and carry the 
bandage up over the left parie- 
tal protuberance, then down 
across the neck to the right ax- 
illa, thus finishing turn 3. Then 
carry the roller-head under the 
arm, up over the front of the 
right shoulder, then to the left 
parietal protuberance, in line of 
course 3, thus finishing course 
4. Continue the course of the 
bandage about the forehead, 
mount the right parietal eminence, and descend diagonally down 
across the back of the neck to the left axilla, thus finishing course 5. 
Pass the bandage under this arm, up over the front of this shoulder, 
and re-mount to the right side of the head, in line of course 5, thus 
finishing turn 6. Make, then, a complete horizontal circuit of the 
head, for course 7, coming down over the left parietal eminence to 
the right axilla for turn 8. Make course 9 similar to course 4, course 
10 to course 5, course n to course 6, slightly overlapping the pre- 
ceding turn in each case, and finally exhaust by horizontal turns 
about the forehead and occiput, there confining as usual. 

Uses. — In cases of burns of the anterior surface of the neck and 
the upper part of the chest, where vicious contraction of the cicatrix 
is to be feared. Also in horizontal wounds of the back of the neck, 
thus aiding in securing the proper coaptation of the parts. This is 
quite a firm bandage, and most any degree of backward flexion of the 
head can be maintained. 

Note.— Turns 4, 6 and 9 have been exaggerated, at their crossing 
upon the back of the neck, in order to show their courses more 



MANUAL OF BANDAGING. 49 

plainly. In other words, they are too angular, as represented in 
the cut. 



DOUBLE POSTERIOR T OF THE HEAD AND THORAX. 

Description.— Same as Double Anterior X of the Head and 

Thorax, page 50. 

Application. — The reverse of that bandage, the head being 
flexed backwards; the application is then essentially the same as seen 
in cut No. 35. 

Uses. — The same as those of the Posterior Figure of 8 of the 
Head and the Axillae, and may be preferred to it. 



FRONTO-DORSAL TRIANGLE. 

Description. — The same as the Occipito-Sternal Triangle 
described on page 51. 

Application. — The reverse of the Occipito-Sternal Triangle. 
Imagine your patient to be with his back to you, in Fig. 36, and the 
application will then be readily understood, as it is so similar. 

Uses. — Mayor designed this to take the place of the Posterior 
8 of the Head and Axillae, and the Double Posterior X °f the Head 
and Thorax, which it does admirably. 



ANTERIOR FIGURE OF 8 OF THE HEAD AND THE AXILLA. 

Description.- — This bandage should be nine yards in length by 
one and three quarter inches in width. 

Application. — See Fig. 34. This bandage is to be applied 
just the reverse to this ; that is, stand in front of your patient, and 
place the initial end at the forehead, flexing the head forwards upon 
the chest. 

Uses. — In cases of burns of the back of the neck, or upper por- 
tion of the back where vicious cicatricial contraction is to be feared. 
Also for transverse wounds of the front part of the neck. This band- 
age is not often employed on account of the inconvenience from the 



50 



BANDAGES OF THE NECK 



crossings of the bandage, which occur upon the patient's face. Either 
the following, or the Occipito-sternal Triangle, is to be preferred 
to it. 



DOUBLE ANTERIOR T OF THE HEAD AND THORAX. 
Description. — I. A broad band, eight or ten inches wide, and 
sufficiently long to encircle the chest. 

II. Two shoulder strips to act as " suspenders " of this broad 
thoracic band. 

III. A bandage three yards long and one and three-quarter inches 
wide. To the superior border of this bandage, at a distance of twenty 
inches from the initial end, is to be sewed (at right angles) a strip 
two feet long, by one and one quarter inches wide. To the inferior 
border (at nearly right angles) are to be sewed two strips, each 
eighteen inches long by one inch wide, at three inches distant, 
each way, from the lateral borders of the strip sewed to the superior 
border of the main bandage ; thus having some eight inches inter- 
vening between the two inferior strips. 

Application. — Encircle the thorax with the broad band, a, con- 
tra- 35. fining by pins or stitches ; and to 
it pin the " suspenders " b, b'. 
This done, place the initial end 
of the roller upon the forehead, 
c-i, and confine by a horizon- 
tal turn, 2 ; carry the single 
band, d, up over the top of the 
head and down under the hori- 
zontal course of the main band- 
age, at the occiput, again re- 
mounting the head and confin- 
ing with a pin or stitches. After 
this, exhaust the roller, c, by 
horizontal courses about the 
forehead and occiput. After 
doing this, flex the head upon 
the chest, to that degree deem- 
Double Anterior t of the Head and Thorax, ed requisite, and confine it there 
by pinning the strips e', e, to the thoracic band, a. 










MANUAL OF BANDAGING. 51 

Uses. — Same as those of the Anterior Figure of 8 of the Head 
and Axillae, and is to be preferred to it. 



OCCTPITO-STEENAL TEIANGLE. 

Description. — I. A triangle one yard long and having a height 
of eighteen inches. 

II. A triangle of the same size folded to a cravat. 

Application. — Place the centre of the cravat at the sternum, 
fig. 36. and conduct both ends back- 

wards, under the axillae, and 
confine with a knot, at the back. 
Place, now, the centre of the 
base of the triangle at the fore- 
head, carry the two extremities 
backwards, over the apex of the 
triangle, to the occiput, crossing 
them here to conduct them for- 
wards, and obliquely downwards 
to the sternum, after having 
pinned them at the sides of the 
head. Flex the head sufficient- 
ly, and then tie them about the 
Occipito-stemai Triangle. cravat. The apex of the tri- 

angle can be confined as in ordinary cases. 

Uses. — Mayor designed this bandage to take the place of the 
Anterior 8 of the Head and Axillae, and the Double Anterior T °f 
the Head and Chest, which it does admirably ; and for readiness of 
application, and the abundant security it gives, it is to be preferred 
to them. 




52 



BANDAGES OF THE NECK. 



FIG. 37. 



FIGUKE OF 8 OF THE HEAD AND AXILLA. 

(Lateral Bandage of the Neck.) 

Description. — This bandage should be six yards long by one 
and three-quarters inches wide. 

Application. — Standing behind your patient, place the initial 

end, i, at the forehead, and 
confine by^a single horizontal 
turn, 2. Having, arrived at the 
occiput, on the third course, 
flex the patient's head on the 
side injured, the right for in- 
stance, and carry the bandage 
down in front of the right shoul- 
der to the axilla, thus finishing 
turn 3. Continue the course of 
the bandage on beneath the 
right axilla, and up to the fore- 
head ; here reverse and confine 
with a pin, thus finishing turn 

4. Turn 5 is to be in the course 
Kgure of 8 of the Head and Axilla. of tum ^ tum 6 of tum ^ and 

so on. At last exhaust the bandage by horizontal turns about the 
forehead and occiput, or the right arm, as a', or a. 

Uses. — In cases of burns of the side of the neck where vicious 
cicatricial contraction is feared ; or, of transverse wounds of the sides 
of the neck, when gaping would otherwise persist. 




PAEIETO-AXILLAEY TKIANGLE AND CKAVAT. 

(Lateral Triangle of the Neck.) 

Description. — I. A triangle having a base one yard in length, 
with a height of sixteen inches. 

II. A triangle of same size folded to a cravat. 



MANUAL OF BANDAGING. 



53 



Application. — Pass the cravat, a, under the left axilla, supposing 
fig. 38. you wish to incline the head to 

the left, and tie in front of the 
shoulder. Place the base of the 
triangle, b, over the left parietal 
region, and carry the two extre- 
mities horizontally around the 
head, cross them, flex the head 
towards the left shoulder, and 
bring them down and tie to the 
cravat. Confine the apex of the 
triangle with a pin, as usual. 

Uses. — This bandage of 
Mayor fully takes the place of 
the preceding, and is far prefer- 

Parieto-Axillary Triangle and Cravat. ,, . , f 

plication and removal is concerned. It is equally efficacious in 
restraining the movements of the head. May be applied to either 
side of the head. 




54 



BANDAGES OF THE UPPER EXTREMITY. 



CHAPTER VII. 



BANDAGES OF THE UPPER EXTREMITY. 



SPIRAL OF ONE FINGER. 



Description.- -This bandage should be one and one-half yards 
in length by three-quarters of an inch in width. 

Application. — Suppose it is the right fore-finger to which 
fig. 39. you wish to apply the bandage. Pronate 

the hand ; after unrolling four or five 
inches of the bandage, place it upon the 
back of the wrist, as i, and confine it by 
a single circular turn, 2. Continue the 
course of the bandage about the wrist till 
you come to the ulnar border, when you 
cross down the back of the hand (course 
3) and continuing the course of the band- 
age onwards along the radial side of the 
forefinger, you encircle this at the tip, 
as course 4. Courses 5, 6, 7, 8, 9, 10 and 
1 1 encircle the diseased member spirally ; 

while course 12 runs obliquely upwards, 
Spiral of one Finger. fa)m ^ ^ finger . deft? acrQSS the back 

of the hand to the radial side of the wrist, partially encircling it, 
when you tie both extremities, as at 13. 

Uses. — For maintaining the coaptation of severed parts, when 
there is a longitudinal wound; also for confining dressings and 
splints to the part. This bandage is applied to any one of the 
fingers, or the thumb, of either hand. 




MANUAL OF BANDAGING. 



55 



POSTERIOR FIGURE OF 8 OF THE THUMB AND WRIST. 

(Spica of the Thumb.) 

Description. — This bandage should be two yards in length by 
three-quarters of an inch in width. 

Application. — If it be the right you wish to bandage, place the 
fig. 40. hand midway between pronation and su- 

pination. Unroll four or five inches of the 
bandage, and thus place it, i, upon the 
back of the wrist, and confine by two cir- 
cular turns, 2 and 3 ; continue on in the 
same course till you come to the ulnar 
border of the hand, when you descend 
obliquely across the back of the hand to 
the radial side of the thumb, at the pha- 
langeal articulation, thus finishing course 
4. Pass under the thumb and then up 
over it, and diagonally upwards to the 
radial side of the wrist, finishing course 5. 
Turns 6, 8, 10, 12 and 14, etc., respec- 
tively follow the course of turn 4 ; while 
those of 7, 9, n, 13 and 15, those of turn 
5. At last exhaust the bandage by circular turns about the wrist, 
and confine by tying. 

Uses.— For confining dressings to the back of the thumb, or the 
first metacarpal space ; also as dressing after the reduction of a 
dislocation of the first phalanx. It can be applied so that the spiral 
shall run downwards, instead of upwards, as we have given ", but the 
descending spiral can rarely be put on so evenly and regularly. 




Posterior Figure of 8 of the 
Thumb and Wrist. 



POSTERIOR FIGUKE OF 8 OF THE HAND AND WRIST. 

Description. — -This bandage should be one and one-half yards 
in length by one and one-quarter inches in width. 



56 



BANDAGES OF THE UPPER EXTREMITY. 



Application. — Place the initial end, i, on the back of the wrist 
— the left, for example, — and confine by 
a circular turn, 2 ; continue the course of 
the bandage about the wrist till you come 
to the radial border, when you descend 
obliquely across the back of the hand to 
the fifth metacarpo-phalangeal articula- 
tion, thus finishing turn 3. Turn 4 is a 
circular course about the metacarpo-pha- 
langeal articulations; whilst course 5 
ascends obliquely across the hand, from 
the radial border of the fore-finger, to the 
ulnar border of the wrist. Turn 6 is a 
simple circle of the wrist. Course 7 is in 
line of course 3, slightly overlapping it ; 
Posterior Figure of 8 of the course 8, in line of course 4 ; course 9, of 

Hand and Wrist. ,-, , , . . , L , t , 

course 5. Exhaust the bandage, at last, by 
simple circles about the wrist, and confine in the ordinary way. 

Uses. — For confining dressings to the back of the hand or wrist, 
as cataplasma, graduated compresses over ganglionic cysts, etc.; also 
as an after-dressing after a dislocation backwards of the os magnum, 
or any of the dislocations backwards of the first row of phalanges. 




ANTERIOR FIGURE OF 8 OF THE HAND AND WRIST. 



Description. — This bandage should be one and one-half yards 
long by one and one-quarter inches wide. 

Application. — Just the reverse of that seen in figure 41 ; 
that is, imagine the palm of the hand presenting, and then apply as 
above described. 

Uses. — To confine dressings to the palm of the hand, and to 
the anterior surface of the wrist ; also, to confine compresses to the 
region of the palmar arches, in case the vessels are wounded, and 
ligation is called for. 



MANUAL OF BANDAGING. 57 

FOUR-TAILED BANDAGE OF THE HAND. 

(Slifig of the Hand.) 

Description. — This bandage should be eighteen inches in 
length by three or four inches in width. 

Application. — Fold the ends together, and then tear, or cut 
them back to within two inches of the folded centre, thus making a 
bandage similar to the compress seen in figure 4, page 17. Place 
the plane of the bandage either upon the palm or the back of the 
hand, according to the seat of injury. Tie the inferior ends about 
the metacarpo-phalangeal articulations ; whilst the superior ends you 
carry obliquely upwards to the wrist, and confined there by tying 
about it. 

Uses. — This bandage is intended to take the place of the Pos- 
terior and Anterior Figure of 8's of the Hand and Wrist, in injuries 
about the palm or the back of the hand. As it is more easily ap- 
plied, it has, perhaps, become a more general favorite.* 



DOUBLE T OF THE BACK OF THE HAND AND WRIST. 

Description. — The main bandage, a, should be some twenty- 
no. 42. eight inches in length by one inch in width. At 
a distance of three inches from the initial end, 
stitch, at right angles, another bandage, b, twenty 
inches long, by three-quarters of an inch wide ; at 
a point two inches from this, stitch, at right 
angles to the plane of the main bandage, and 
Diagram. parallel to b, another bandage, c, of the same 
dimensions as b. 

Application. — Place the initial end of the bandage, a, upon 




Note. — The systems of Triangles and Cravats are so readily applied to the 
hand, and are in such common use by the laity, even, no description of 
them is thought necessary. 



r>$ 



BANDAGES OF THE UPPER EXTREMITY 




Double T of the Back of the 
Hand and Wrist. 



fig. 43. the back of the wrist, so that the first 

perpendicular portion of the bandage, 
b, will correspond to the first interosse- 
ous space, and the portion c, with the 
fourth interosseous space. Confine the 
initial end by a single circular turn, 2, 
about the wrist. Carry the portion b 
down the first interosseous space, around 
over the palmer surface of the first joint 
of the index finger, and then back, 
over the second interosseous space, 
to the wrist; this done, make another 
circular turn about the wrist with the 
main bandage, as turn 3, running over 
the recurrent portion of b at the wrist. 
Continue these circular turns of a until the bandage is exhausted, 
when confine with a pin. Conduct, now, the other perpendicular 
portion, c, down the fourth interosseous space, across the palmer 
surface of the metacarpo-phalangeal articulation of the ring-finger, 
back, over the third interosseous space, to the wrist, here tying with 
the end 01 the first portion, b, as at d, after the requisite amount of 
extension of the palmar tissues, or fingers, has been obtained. 

Uses. — In cases of burns of the palm of the hand, or extensive 
suppurations, where vicious cicatricial contractions are to be feared. 
In cases of injuries of the finger-clefts, from burns or otherwise ; here 
using compresses, soaked in carbolized oil, to prevent the union of 
the sides of the fingers from " angular " granulation. Also for con- 
fining dressings to the back of the hand. 

Variety. — Single T of the Back of the Hand and Wrist. — In this 
case but one perpendicular portion of the bandage is used, as b, or 
c ; it being applied between any finger-clefts desired, and in a manner 
similar to the above. 

The uses are similar to the Double "T just described, only are 
more limited. 



MANUAL OF BANDAGING. 



59 



PERFORATED T OF THE HAND AND WRIST. 



FIG. 44. 




Diagram. 

Application. 

FIG. 45. 



Description. — A bandage, a, a', eighteen 
inches in length by one inch in width. At 
the middle of this, at right angles to it, stitch 
a piece of linen, or flannel, b, twelve inches in 
length by four inches in width, having five 
perforations ; the first, corresponding, from its 
size and position, with the thumb, as c. The 
other perforations are made at such distance 
from each other, and of such size, as will read- 
ily admit the fingers. 
Suppose it to be the right hand. Carry the 
fingers and thumb through their respec- 
tive perforations in the portion b, and 
place the portion a at the back of the 
wrist. Carry forwards the lower portion 
of b (see figure 44), up across the palm 
of the hand, folding it about the wrist, 
as d, d'. Conduct, now, the two extre- 
mities of the main bandage (a, a', figure 
44) circularly about the wrist, binding 
down the recurrent portion of b (d, d'); 
and when exhausted, tie the ends to- 
gether, as at c. 

Uses. — Designed to take the place 
of the Double or Single T Bandage of 
the Hand and Wrist ; also for confining 
Perforated t of the Hand and dressings to the palm of the hand, as 

Wrist. 

well as to the dorsal portion. 




CARPO-DIG1TO-PALMAR TRIANGLE. 

Description. — This should be a triangle having a base twenty- 
four inches in length and a height of twelve inches. 



60 



BANDAGES OF THE UPPER EXTREMITY. 



Application. — Place the base of the triangle upon the palmar 
fig. 46. surface of the wrist ; conduct both extremi- 

ties circularly around the wrist, tying at the 
back. Fold the sides of the triangle over 
the dorsum of the hand, and carry the apex 
of the triangle up over the back of the fingers 
(extending them as circumstances demand) 
to the wrist, as at b, there confining. 

Uses. — For maintaining dressings to the 
palm of the hand, and also for extending the 
fingers upon the forearm, in cases of burns of 
the palm, where vicious cicatrization is to be 
feared ; also in transverse wounds of the 

back of the hand. In these latter cases it takes the place of the 

Double T of the Back of the Hand and Wrist. 




C arpo-Digito-Palmar 
Triangle. 



DOUBLE ANTERIOR T OF THE HAND AND WRIST. 

Description. — The same as the Double T °f tne Back of the 
Hand and Wrist (page 57). 

Application. — The reverse of the Double T °f tne Back of 
the Hand and Wrist ; that is, it is to be applied to the front of the 
hand. 

Uses. — Similar to the above in cases of finger-cleft injuries, or 
after web-finger operations. Also in cases of burns across the back 
of the metacarpo-phalangeal articulations, or transverse wounds 
across the front of the same joints. 

Variety. — Single Anterior T of the Hand and Wrist. — Only one 
perpendicular, or finger-cleft, portion of the bandage is to be used. 
It can be applied to any of the finger-clefts desired. 

The uses are similar to the Double "J"> on ^y niore limited. 



CARPO-DIGITO-DORSAL TRIANGLE. 

Description. — Same as Carpo-Digito-Palmar Triangle. 
Application. — The reverse of that seen in figure 46, in that 
you place the base of the triangle at the back of the wrist, confining 



MANUAL OF BANDAGING. 



61 



as in the preceding case. Afterwards fold the apex up over the palm 
of the hand, thus flexing the fingers upon the forearm, and confine 
at the wrist. 

Uses. — For maintaining dressings upon the hand, and for main- 
taining the fingers in a state of flexion when vicious cicatrization is 
to be feared upon the back of the hand ; also, in cases of transverse 
wounds of the palm of the hand. It is then designed to take the 
place of the Double Anterior T °f the Hand and Wrist. 



SPIRAL OF ALL THE FINGERS. 

(Gauntlet.) 

Description.— This should be a bandage ten yards in length 
by three-quarters of an inch in width. 

Application. — Suppose it be the right hand to which it is to be 
fig. 47. applied. After letting drop four 

or five inches (enough to tie 
with) of the initial end, place 
the bandage upon the back of 
the wrist, i, and confine by the 
circular turns, 2 and 3 ; after- 
wards coming obliquely down 
across the back of the hand, 
from the radial side, to the little 
finger, finishing course 4. Con- 
tinue the bandage outwards to 
the tip of this finger, making a 
circular turn, 5, and the spiral 
turns 6, 7, 8, 9, 10, n, 12, 13 
and 14 about the same member ; 
then conduct the bandage up- 
wards and outwards from the 
fourth finger-cleft to the palmar 
surface of the wrist, thus finishing course 15. Course 16 is essen- 
tially that of course 4, with this difference : it goes to the ring finger; 
this finger is spirally bandaged, and the recurrent course, 27, of the 
bandage is similar to that ot course 15. Each of the remaining 




Spiral of all the Fingers. 



62 



BANDAGES OF THE UPPER EXTREMITY. 



fingers are similarly wound, and at last both ends of the bandage are 
tied at the back of the wrist, or forearm, 62. 

Uses. — In cases of fracture, or dislocation of the phalanges; and 
burns, or other wounds of the fingers and hand, where vicious cica- 
tricial contraction is to be feared, or after an operation for web- 
finger. 



fig. 48. 



SPIRAL OF THE FINGERS AND THE HAND. 

Description. — This bandage should be three yards, or more, 
in length, and one and one-quarter inches in width. 

Application. — Place the' initial end of the bandage, 1, at or 
near the extremities of the fingers, and 
confine by the spiral turn 2 ; make six 
other spiro-circular turns about the 
fingers,and on the 9th, 10th, nth, 12th, 
etc., courses make the reverse to each 
turn, so as to accommodate the obli- 
quity of the thumb, and thus prevent 
the bandage slipping off. At last ex- 
haust by simple circular turns about 
the wrist, or lower part of the forearm, 
and confine with the pin as usual. 

Uses. — In cases of fracture, or dis- 
location, of the phalanges ; and also for 
confining dressings to any part of the 
hand and wrist. If the fingers should 
each, separately, demand compression, 
then the Spiral of All the Fingers (The 
Gauntlet) should be employed. 




Spiral of the Fingers and the 
Hand. 



THE SHEATH OF THE FINGERS. 

Description. — Instead of the more elaborate ones recom- 
mended by some authors, you can use the fingers from a large glove; 
or, if the whole hand is to be enveloped, a mitten. 



MANUAL OF BANDAGING. 



M 



Uses. — In the simpler injuries about the hand where the more 
complex bandages are hardly called for. 



FIGURE OF 8 EXTENSOR OF THE HAND UPON THE FOREARM. 

Description. — This bandage should be six yards in length by 
one and a half inches in width, and rolled into two equal heads. 
Application. — Place the plane of the roller upon the back of 
fig. 49. the hand, i, conduct both heads 

to the palm, cross them, one 
above the other, and remount 
to the back, crossing them 
there, 2 2, and conduct them 
to the palm again. Re-crossing 
them, carry the heads upwards 
across the arm, 3, 3, to a' point 
above the olecranon process, 
the hand being sufficiently ex- 
tended ; make a circle of the 
arm at this point, 4, 4, crossing 
the heads before and behind, 
and at last descend upon the 
arm again, 5, 5, to make another 
circuit about the hand, thence 
to remount to the elbow again. 
Finally exhaust both heads by 
Figure of 8 Extensor of the Hand upon the circular turns above the elbow, 
Forearm. confining as usual. 

Uses. — In cases of burns of the palmar surface of the hand, wrist 
or forearm, where vicious cicatricial contraction is to be feared, and 
in all other cases, where extension of the hand upon the forearm is 
desired, as in transverse wounds of the back of the wrist. 




FIGURE OF 8 FLEXOR OF THE HAND UPON THE FOREARM. 

Description.— This bandage should be six yards in length by 
one and a half inches in width, and rolled into two equal heads. 



64 



BANDAGES OF THE UPPER EXTREMITY. 



Application. — Similar to the preceding; the plane of the 
bandage being placed at the palm of the hand, the member being 
flexed upon the forearm. Courses i and 2 are to be made as in the 
Extensor of the Figure of 8 of the Hand upon the Forearm, and the 
heads carried above the elbow and the remaining courses made in 
a similar manner to those of the preceding bandage. 

Uses. — In maintaining forward flexion of the hand upon 
the forearm, as in case of burns of the back of the hand, wrist and 
forearm, where vicious cicatricial contraction is to be feared. Also 
in cases of transverse wounds of the forepart of the wrist, where a 
tendency to gaping occurs. 



CAEPO-OLECEANON CEAVAT. 

Description. — I. Two cravats, each eighteen inches in length. 

II. A third cravat, thirty- six inches in length. 

fig. 50. Application. — Tie one of 

the short cravats about the 
hand, as at a ; and then tie 
the other about the arm, above 
the olecranon process, as at 
b. Extend, now, the hand 
upon the forearm, and confine 
it by tying the long cravat, c, 
between, and to, them. 

Uses. — Same as the Figure 
of 8 Extensor. As these cravats 
are easier applied, and full as 
safe as the roller bandage, they 
are to be recommended to it. 
Variety. — If need be, a 
Flexor variety of this cravat 
may be employed. In this 
case, the hand is flexed upon 
the anterior surface of the 
forearm, by running the long 
cravat, c, down the anterior 
surfaceTof the member. This 




Carpo-Olecranon Cravat. 



MANUAL OF BANDAGING. 65 

bandage would then take the place of the Figure of 8 Flexor of the 
Hand upon the Forearm, just described. 



SIMPLE SPIRAL OF THE FOREARM. 

Description. — This bandage should be two yards in length 
by one and a half inches in width. 

Application. — Place the initial end at the wrist and confine 
by a circular turn above it ; exhaust the bandage by encircling the 
arm with spiraliform turns, as you see in the upper courses of the 
bandage depicted upon page 62. 

Uses. — To retain dressings upon the forearm. 



REVERSED SPIRAL OF THE SUPERIOR EXTREMITY. 
(Roller of the Superior Extremity.) 

Description. — This should be twelve yards in length by one 
and a half inches in width. 

Application. — See figure 10, page 22. This bandage is to 
be applied as here represented, the courses being continued upwards 
to the axilla ; here confining in the usual way. 

Uses. — Most generally employed in cases of fractures, etc., to 
restrain muscular action, swelling, and to favor the return of venous 
blood to the vena cava superior. When employed, the surgeon 
should guard himself that he does not allow unequal pressure at any 
of the courses of the bandage. Should he have one part of the member 
more tightly constricted than another, he will only increase the mis- 
chief already done by the accident by favoring the development of 
gangrene, from venous stagnation, at the more constricted portions. 
When evenly and smoothly applied, this bandage is of great service 
to the surgeon ; when inaptly applied, a source of great danger to his 
patient, and chagrin to himself. (See note at foot of page 67). 

ANTERIOR FIGURE OF 8 OF THE ELBOW. 

Description. — This bandage should be two and a half yards in 
length by one and a half inches in width. 



BANDAGES OF THE UPPER EXTREMITY. 




Anterior Figure of 8 of the 
Elbow. 



Application. — Suppose it to be the right arm to be bandaged. 
ftg. 51. Place the initial end of the bandage, i, 

above the bend of the elbow, and confine 
by a single circular turn, 2. Continue on 
in the same direction till you get to the 
outside of the arm, when you descend 
diagonally across the front of the joint, 
to a point four or five inches below it, 
thus finishing turn 3. Turn 4 is a circu- 
lar course about the upper portion of the 
forearm ; turn 5, a spiral turn upwards to 
the inside of the arm above the bend of 
the elbow ; whilst turn 6 is in course of 
turn 3 ; turn 7, of course 5, and so on ; at 
last exhaust by circular turns about the 
arm, and confine as usual. 

A variation can be made, and to good advantage sometimes, by 
making course 6 to be a circular turn about the arm, as course 2 ; 
course 7 then being the same as course 6 in the figure, whilst course 
8 is a circle of the forearm, as course 4 in the wood-cut ; course 9 
would then take the place of course 7 in the cut. 

Uses. — Generally to fix a compress over the median-cephalic 
vein after venesection. Can be employed in cases of wounds in that 
region, or for maintaining dressings thereto. 

Variety. — By making similar courses of the bandage upon the 
posterior surface of the arm and forearm, you get the Posterior Fig- 
ure of 8 of the Elbow. 

The Uses of this variety are essentially to confine dressings about 
the back of the joint. 

A Triangle of the Elbow and also a Four-tailed Bandage (Anterior 
and Posterior) have been devised to take the place of the roller var- 
ieties. But these are so readily applied that no further description 
is necessary. 



CERVIOO-ULNAR CRAVAT AND TRIANGLE. 
Description.— I. There should be a cravat two feet in length. 



MANUAL OF BANDAGING. 



07 



II. A triangle having a base of two feet, and a height of twelve 
inches. 

Application. — Tie the cravat a 



fig. oi 



about the neck. Flex the 
forearm, at right angles, 
upon the arm ; then place 
the base of the triangle 
at the ulnar border of the 
hand, the apex, b, being at 
the elbow, and tie the two 
extremities of the triangle 
into the cravat of the neck, 
as at c. 

Uses. — In cases of 
burns of the back part of 
the elbow or transverse 
wounds of the front of the 
joint ; also, as a "sling", in 
cases of injuries of the forearm, or hand, where elevation, or "rest", 
of the part may seem demanded. It may, or may not, be applied 
over the clothing. 




Cervico-Ulnar Cravat and Triangle. 



SPIRAL OF THE ARM. 

Description.- -This bandage should be one and one-half yards 
in length by one and a half inches in width. 

Application. — -Essentially the same as that of the Spiral of the 
Forearm, described upon page 65, except that you begin at the 
elbow. 

Uses. — To confine dressings to the arm-regions, or for the sup- 
port of the edges of longitudinal wounds, thus securing coaptation. 
It may or may not be applied with " reverses "; yet, should the biceps 
be well developed, it would be best to employ them, otherwise the 
bandage would be in great danger of slipping down.* 



Note. — See, for all of these Spiral bandages, the description of the 
Figure of 8 Spiral of the Extremities described upon a following page. 



68 



BANDAGES OF THE UPPER EXTREMITY. 



FOUR-TAILED BANDAGE OF THE SHOULDER 

Description. — This should be a piece of cloth some forty-eigh t 
inches in length and five or six inches in width. Fold, lengthwise, 
at the centre, and then cut, or tear, back the extremities to within 
four or five inches of this point, thus shaping it something like the 
" sling compress," figure 4, page 17. 

Application. — Place the plane of the bandage over the diseased 
shoulder, and carry the two superior ends of the bandage obliquely 
down across the chest (one upon its anterior, and the other upon its 
posterior surface) and tie them below the opposite axilla. Then 
carry the two inferior extremities of the bandage up around the neck 
(one in front and the other behind), and confine them by tying. 

Uses. — To confine dressings about the shoulders. It furnishes a 
very handy, though not very firm variety of dressing. 



fig. 53. 



LAEGE OBLIQUE TRIANGLE OF THE ARM AND CHEST. 

(Large Triangular "Sling" of the Arm.) 

Description. — A piece of linen or flannel folded to the form of 
a triangle, so that it shall have a base of some sixty inches, and a 
height of twenty-four. 

Application. — Having flexed the forearm to a right angle with 

the arm, fold it to the breast ; 
place the base of the triangle, 
a, at the hand, and carry one 
end backwards under the axilla 
of the diseased member to bring 
forwards, across the back, to the 
opposite shoulder, there to tie 
with its fellow, b, that ascends 
directly upwards across the 
front part of the chest to the 
same side. The apex of the 
triangle, c, is then to be brought 
forward and pinned, as you see 
in the wood-cut. 




Large Oblique Triangle of the Arm and 
the Chest. 



MANUAL OF BANDAGING. 69 

Uses. — To support the arm and forearm in cases of injury. 
The cut represents the bandage as being applied over the naked 
body ; it is applied with equal frequency over the clothing. 



TRIANGULAR FRONT OF THE FOREARM. 

(The Ordinary Arm-Sling.) 

Description. — This should be a triangle having a base of 
forty-eight inches, and a height of twenty inches. The laity usually 
make it from a large shawl folded to a wide cravat. 

Application. — Having flexed the forearm upon the arm, fold it 
fig. 54. to the chest, and place the 

middle of the base of the 
triangle at the hand, a, and 
conduct the extremities up 
and around the neck, and 
confine them by tying. The 
apex of the triangle can 
now be folded under the 
arm to a sufficient extent 
to have the bandage fit 
easily, and yet furnish effi- 
cient support. 

Uses. — This, in some 
measure, takes the place of 

the preceding, yet does not 

Triangular Front of the Forearm. r n , T , 

fully supplant it. Is used 

more as a support of the hand, or lower part of the forearm. This 

bandage may, or may not, be applied over the naked bod)''. 




SMALL FRONT OF THE HAND OR FOREARM. 

(Small Sling of the Hand or Forearm.) 

Description. — A rectangular piece of cloth, eighteen inches 
long by nine inches wide. 
10 



70 



BANDAGES OF THE UPPER EXTREMITY. 



FIG. 55. 




Small Front of the Hand or Fore- 
arm. 



Application. — Flex the 
forearm at right angles to 
the arm, and fold to the 
chest. Place the middle of 
the bandage beneath the hand 
and forearm, carrying both 
ends upwards and pinning 
them to the clothing on the 
breast. 

Uses. — As a support ot 
the hand or forearm in cases 
of minor injuries. 



POSTEKIOR DOUBLE FIGURE OF 8 OF THE ELBOW AND 
THE OPPOSITE AXILLA. 

Description. — This bandage should be a cravat two yards in 
length by eight or ten inches in width. It can be made out of a 
small shawl, if necessary. 

Application. — Standing in front of your patient, and holding 
fig. 56. the bandage with its centre 

across the palm of the 
hand, place the centre of 
the cravat over the elbow, 
a, of the injured member, 
both ends hanging down 
towards the floor. Seize 
the innermost extremity 
and carry it, a, across the 
inside of the arm, under 
the diseased axilla, up in 
front of the same axilla and 
over the same shoulder, 
and then obliquely down across the back, b, to the opposite axilla, 
where you surround the shoulder with the same extremity of the 
cravat, at last entrusting it to the care of an assistant. Carry the 




Posterior Double Figure of 8 of the Elbow 
and the Opposite Axilla. 



MANUAL OF BANDAGING. 71 

other extremity of the cravat forwards across the bend of the elbow, 
and over the other end of the bandage, then backwards, under 
the diseased axilla, as c, and then finally upwards to the opposite 
shoulder, there confining by tying, after the arm has been sufficiently 
extended backwards. You will then need a " sling," for the hori- 
zontal support of the forearm and hand, which can be pinned to the 
cravat as it crosses the shoulder, or about the neck. 

Uses. — This bandage was designed by Dr. E. M. Moore to 
take the place of the numerous dressings for fractured clavicle. It 
dispenses with the "axillary pad," and the more complicated system 
of Fox and Desault, and seems, from certain anatomical reasons, to 
be superior to theirs for maintaining a coaptation of the clavicular 
extremities. It certainly has the argument of simplicity in its 
favor. 



72 



BANDAGES OF THE BODY. 



CHAPTER VIII. 



BANDAGES OF THE BODY. 



SPIRAL OF THE CHEST. 



Description. — This bandage should be nine yards in length 
by two inches in width. 

Application. — Dropping about one yard of the bandage ob- 
FIG - 57 - liquely down across the 

chest from the top of one 
of the shoulders, the left, 
for instance, carry the head 
of the bandage down the 
back to a level with the 
arm-pits. Make now the 
spiral turns 2, 3, 4, 5, 6, 7, 
8, and 9 about the chest, 
and at last confine by pin- 
ning, as at 1 o. Carry, now, 
the free end of the band- 
age, n, which you let fall 
at the beginning of the ap- 
plication, obliquely up over the chest to the opposite shoulder from 
whence dropped, and confine, by pinning, to the posterior spiral 
turns. 

Uses. — This bandage is employed where compression about 
the chest is needed, as in cases of fractures of the ribs, sternum or 
vertebrae, or separation of the rib-cartilages. Also in wounds of the 
abdomen with presentation of the viscera. It is also of use in 
emphysema, or after thoracico-paracentesis, thus compressing the 
walls of the chest, if they be much expanded. 




Spiral of the Chest. 



MANUAL OP BANDAGING. 



73 



Variety.- -If the roller-head should be carried down to the 
superior margins of the inferior ribs, and then the circular spirals 
made, we would have the Spiral of the Abdomen. Full a yard more 
of bandage is, in this case, required. It can also be extended down 
upon the abdomen, from the "Spiral of the Chest," by having the 
bandage as long again as needed for the performance of the chest 
spiral. The uses of these varieties are similar to those of the above. 
They are especially applicable where abdominal compression is de- 
sired, as after paracentesis abdominis, eviscerating wounds, drop- 
sies, ovarian tumors, etc. 



CIRCULAR-QUADRILATERAL OF THE CHEST, AND DORSAL 
CERVICO-STERNAL TRIANGLE. 

Description. — I. There should be a quadrilateral wide enough 
to cover in the thoracic region, and long enough to encircle, one 
or more times, the body, and may or may not be of several thick- 
nesses. 

II. A triangle having a base one yard in length, and a height of 
eighteen inches. 

Application. — Encircle the body with the quadrilateral portion 
fig. 58. of the bandage, as a, and 

confine by pins or stitches. 
This done, place the centre 
of the base of the triangle 
at the nape of the neck, 
carry the two ends, b, b, 
forwards and downwards 
across the front of the chest, 
and confine them with pins 
to the quadrilateral, or 
thoracico - encircling por- 
tion. Then carry the apex 
of the triangle down the 
back, and pin it to the 
quadrilateral portion ot the 
bandage at the back, so as to prevent it slipping down. 




Circular-Quadrilateral of the Chest, and Dorsal 
Cervico-Sternal Triangle. 



74 



BANDAGES OF THE BODY. 



Uses. — For confining dressings to any portion of the thoracic 
regions ; also for supporting the walls of the chest, in case of injury 
or disease, where the respiratory movements are to be confined. 

Variety. — By widening the quadrilateral portion of the band- 
age, a, or by dropping it farther down the body, so as to encircle the 
abdomen, we get the Circular- Quadrilateral of the Abdomen, and the 
Dorsal Cervico-Sternal Triangle; or, if the bandage be wide enough 
to cover both the thoracic and abdominal regions, the Circular- Quad- 
rilateral of the Abdomen and Thorax, and the Dorsal Cervico-Sternal 
Triangle. In either of the cases two strips should be passed from the 
anterior surface of the quadrilateral to its posterior surface, across 
the perinaeum, thus preventing the bandage from slipping upwards. 

The uses of these bandages are to furnish support to the ab- 
domen, as well as the thorax, after ovariotomy, paracentesis abdo- 
minis, or other injuries of the abdominal wall. 



ANTEEIOE THOKACICO-SCAPULAK TRIANGLE. 



Description. — This bandage should be made of a triangle 
having a base one and one-quarter yards in length, and a height of 
eighteen or twenty inches. 

Application. — Place the base of the triangle, a, at the inferior 
fig. 59. and middle portion of the chest. 

Carry the two ends, b, b, hori- 
zontally about the body, and tie 
at the back. Then carry the 
apex of the triangle, c, up across 
the chest, over the shoulder dis- 
eased, and then down to the 
ends tied at the back, where it is 
to be confined. 

Uses. — To retain dressings 
upon either of the lateral-anterior 
surfaces, or the anterior surface, of the chest. 

Variety. — By placing the base of the triangle at the back, and 
then similarly applying, you get the Posterior Thoracico-Scapular 




Anterior Thoracico-Scapular Triangle. 



MANUAL OF BANDAGING. 



75 



Triangle, which is useful in confining dressings to either the posterior 
or lateral surfaces of the thorax. 



FIGURE OF 8 OF THE NECK AND AXILLA. 

(Spica of the Shoulder.) 
Description. — This bandage should be made from a roller, six 
yards in length by two inches in width. 

Application.— Place the initial end of the bandage at the side 
fig. 60. of the neck, i ; confine 

by a single horizontal 
circular turn, 2. Continue 
the course of the band- 
age about the neck, at 
last crossing down to 
the axilla from over the 
back of the shoulder, 
thus finishing course 3. 
Course 4 is made by 
carrying the roller-head 
up over the anterior sur- 
face of the shoulder, from under the axilla, to the back of the neck. 
Course 5 is made the same as course 3 ; course 6, as course 4 ; 
course 7, as course 5 ; course 8, as course 6, and so on. At last 
exhaust the bandage by a single horizontal turn about the neck, and 
confine as usual. 

Uses. — To confine dressings to the clavicular, sub-clavicular, 
and axillary regions ; also, upon the shoulder. 




Figure of 8 of the Neck and Axilla. 



CRAVAT OF THE NECK AND AXILLA. 

Description. — A cravat one yard in length. 

Application. — Standing at the side of your patient, place the 
centre of the cravat beneath the diseased axilla. Carry, now, the 
posterior extremity up over the scapular region, across the top of the 
shoulder, and around over the front of the neck to the opposite side, 
thus imitating course 7 of the preceding bandage, only making it in 



76 



BANDAGED OF THE BODY. 



the opposite direction ; viz., upwards. Then carry the anterior 
extremity up over the front of the diseased axilla and shoulder to the 
back of the neck (imitating course 8 of the preceding bandage) to 
tie with its fellow there. 

Uses. — Similar to those for which The Figure of 8 of the Neck 
and Axilla is employed. 



FIGUEE OF 8 OF THE SHOULDER AND OPPOSITE AXILLA. 
(Descending Spica of the Shoulder.) 

Description. — This should be made from a roller, eight yards 
in length by two inches in width. 

Application. — Place the initial end of the bandage upon the 
FIG - 61. right arm (supposing 

it to be the right 
shoulder that you 
wish to cover) and 
confine it by two hor- 
izontal circular turns, 
2 and 3, about the 
arm. Turn 4 make 
by mounting up to 
the right side of the 
neck (from the back) 
and passing diagonal- 
ly downwards across 
the chest to the left axilla. Passing under this axilla remount to the 
right side of the neck (across the back), and then descend to the 
right axilla, thus finishing course 5. Course 6, is similar to that of 
course 4 ; course 7, to that of course 5, and so on until the bandage 
is exhausted, at last confine by pinning. 

Uses.— Is used to maintain dressings upon the shoulder, or 
acromioclavicular region, arm-pit, or axilla. 

Variety. — The Ascending Spica of she Shoulder is applied in a 
very similar manner, the only difference being that course 4 takes 
the place of course 14, and course 5 the place of course 13, etc., as 




Figure of 8 of the Shoulder aud Opposite Axilla. 



MANUAL OF BANDAGING. 



77 



shown in the cut ; in other words, you ascend gradually upwards to 
the neck. The descending variety is preferable, as it gives greater 
solidity. 



SIMPLE BIAXILLARY CRAVAT. 

Description. —This should be a cravat (a triangle folded to 
this form) one yard in length. 

Application. — Place the middle of the cravat in front of the 
fig. 62. axilla of the diseased 

side, as a ; carry both 
extremities upwards 
over the same shoul- 
der as b, b', there 
crossing them. Then 
conduct the extremi- 
ty that passes over 
the front of the axilla, 
b, backwards over the 
shoulder and back, to 
the opposite axilla, 
and tie to the other extremity, b', that has been passed somewhat 
obliquely across the breast, as at c. Afterwards pin one to the other 
at the crossing-point, d. 

Xj ses# — To confine dressings about the axillary region and 
shoulder, also for bringing the shoulder forwards upon the chest in 
cases of wounds at the front of the part, or of burns upon the poste- 
rior, or scapular, regions where vicious cicatrization may be feared. 




Simple Biaxillary Cravat. 



COMPOUND BIAXILLARY CRAVAT. 



Description. — This bandage is made from two cravats, each 
being one yard in length, and made similarly to the Simple Bi- 
axillary. 

Application. — Placing one of the cravats, the centre, beneath 
11 



78 



BANDAGES OF THE BODY. 



fig. 63. one axilla, the right, for in- 

stance, conduct the two ends 
upwards and tie at the 
shoulder, as a. Place, now, 
the other cravat, beneath the 
opposite axilla, carry one 
extremity forwards, obliquely 
upwards across the chest, 
and the other obliquely up- 
wards across the back, to 
the opposite shoulder, pas- 
sing one end through the noose made by the cravat, a, first applied, 
and confine by tying, as at b. 

Uses. — Similar to the above. It also affords means for confin- 
ing dressings to both axillary regions simultaneously. 




Compound Biaxillary Cravat. 



CEOSS OF ONE MAMMA. 
Description.— This bandage is made from a roller, eight yards 
in length by two inches in width. 

Application. — Place the initial end of the bandage, i, below 
fig. 64. the diseased gland, the left for 

example, and confine by a hori- 
zontal circular turn about the 
body, 2. Continue on around 
the body till you come to a 
point below the diseased mam- 
ma, when you ascend obliquely 
across the chest to the opposite 
shoulder (the right in this case) 
thus finishing course 3. Course 
4 is a horizontal circular turn 
about the body, in line of 
courses 1 and 2 ; whilst course 5 
is similar to that of course 3. 
Continue on in the same man- 
ner till the bandage is exhaust- 
ed, when you confine it by pinning, as usual. 




Cross of One Mamma. 



MANUAL OF BANDAGING. 



79 



Uses. — As a "sling," or support for an inflamed breast ; and 
also for exercising a compression upon the gland, when occassion 
may demand it. 



TRIANGLE OF THE MAMMA. 
Description. — This should be made from a triangle having a 
base one yard in length and a height of eighteen inches. 

Application. — Placing the base of the triangle, a, at the xiphoid 
FIG - 65 - cartilage, carry one end oblique- 

ly up over the opposite shoulder, 
B, and the other end, b', below 
the axilla of the diseased side, 
and tie them together at the 
back. The apex of the triangle, 
c, is then to be carried upwards 
over the shoulder of the diseased 
side, and confined to the extrem- 
ities of the triangle, at the back. 




Triangle of the Mamma. 



Uses. — Similar to the preced- 
ing; but it is more especially 
adapted, than it, for retaining cataplasms and other dressings to the 
gland, and the region about it. Is more easily applied than the 
above, and makes an excellent suspensory bandage for the mamma. 



Description. 

FIG. 




BOURSE OF THE MAMMA. 

—A piece of lint, ten inches in length and eight 
inches in width when folded at the centre. Cut 
then the folded corners a and b off by the 
dotted lines o-d, and e-f; stitch, then, the 
whole together from G to f ; viz. g-o-d-e-f. 
This done, to each of the two corners at g, 
and the two at h, stitch a narrow strip suffi- 
ciently long to meet and tie, with its fellow, 
(the two inferior) about the body, and (the two 
superior) about the neck. 



80 



BANDAGES OF TEE BODY. 



Application. — Introduce the diseased gland into the bourse A, 
fig. 67. carry the two ends, b and b', around 

the neck, the one on one side, and 
the other upon the other, and confine 
them by tying. Conduct, now, the 
two inferior ends, c and c', hori- 
zontally about the chest, and tie 
them either there, or, after crossing 
them, bring forwards and tie in 
front. 

Uses. — As a suspensory of the 
gland in cases of hypertrophy, or 
extreme naccidity of the thoracic walls, or disease. Also useful in 
confining cataplasmata, or other dressings. 




Bourse of the Mamma. 



CEOSS OF THE TWO MAMM.E. 

Description.— This bandage should be made from a roller, 
twelve yards in length by two inches in width. 

Application. — Place the initial end midway between the lower 

extremity of the xiphoid cartilage 
and the umbilicus, and, going 
from right to left, confine it by a 
single horizontal turn, 2. Continue 
on in the same course, till you 
come to the right side of the chest 
when you mount obliquely up- 
wards across the chest to the left 
shoulder, thus finishing course 3. 
Course 4 is a horizontal turn about 
the chest. Continue on about the 
body, horizontally, till you get to 
the left scapular region, when you mount obliquely upwards across 
the back, to the right side of the neck, and then descend obliquely 
downwards across the front of the chest, below the left mamma, thus 
finishing course 5. Course 6 is made similarly to course 3 ; course 




Cross of the Two Mammae. 



MANUAL OF BANDAOINO. 



81 



7, to course 4 ; course 8, to course 5 ; course 9, to course 6 ; course 
10, to course 7 ; course 11, to course 8 ; course 12, to course 9, and 
so on until the roller is exhausted, when you confine as usual. 

Uses. — In case of disease of both breasts where suspension is 
required ; also for compression, and for retaining of dressings. It is 
not a very stable bandage, besides being open to the objection of 
cording the neck somewhat. For retaining topical dressings, or for 
suspension, the triangular mammary caps, see figure 65, would be 
preferable. 

Note. — Mayor's system may be used in making this bimammary 
bandage by simply applying the Triangular Caps of the Mammae, 
one to each gland ; the two apices being confined as described upon 
page 79, or else tied or pinned together. This would then be known 
as The Bimammary Triangle. 

Two Bourses may also be employed; each being made and 
applied similarly to that one described upon pages 79 and 80. 



POSTEKIOK FIGUKE OF 8 OF THE SHOULDEKS. 

(The Posterior "Star" Bandage of the Old Authors.) 

Description. — This bandage is made from a roller, eight yards 
in length by two inches in width. 

Application. — Place the initial end, 1, at the middle and 
fig. 96. posterior part of the left 

arm. Confine it by two 
circular turns about the 
arm, 2 and 3. Continue on 
in the same course till you 
reach the anterior surface 
of the arm, when you as- 
cend obliquely across the 
axilla and chest to the left 
side of the neck ; from here 
you descend obliquely 
across the back, to and 




Posterior Figure of 8 of the Shoulders. 



beneath the right axilla,thus 
finishing course 4. Carry 



82 



BANDAGES OF THE BODY. 



the roller under this axilla up to the top of the same shoulder, and 
obliquely down across the back to the left axilla, thus finishing 
course 5. Course 6 is made similarly to course 4 ; course 7, to 
course 5 ; course 8, to course 6 ; course 9, to course 7, and so on 
until the bandage is exhausted, when you confine as usual. 

Uses. — For retaining dressings upon either the anterior or 
posterior surface of the chest ; for fixing the shoulders backward in 
case of burns of the chest, or backward displacement of the sternal 
end of the clavicle, and also for assisting in holding in coaptation the 
ends of a broken clavicle, or clavicles. Also of use in luxations of 
the acromial end of the clavicle. It is necessary to have consider- 
able cotton-wool, or some like substance, in the axillae, in order to 
guard against chafing of the parts. 



SIMPLE DOESAL BIAXILLAEY CEAVAT. 

Description. — This bandage is made from a cravat one and 
one-half yards in length. 

Application. — Place the middle of the cravat across the inter 
fig. 70. clavicular space, a. Carry one 

extremity down below one axilla, 
the right for example, and up over 
the same shoulder, b. Carry the 
other extremity up over the other 
shoulder, b', down in front of and 
beneath the same axilla, at last 
confine it to the other extremity, 
after you have sufficiently extended 
the shoulders backwards. 

Uses. — This bandage of Mayor 

Simple Dorsal Biaxillary Cravat. takes ^ place Qf ^ preceding> 

and may be preferred to it for its simplicity. 




COMPOUND DOESAL BIAXILLAEY CEAVAT. 

Description. — I. A cravat one yard in length. 
II. Another cravat two feet in length. 



MANUAL OF BANDAGING. 




Compound Dorsal Biaxillary Cravat. 



Application. — Tie the shortest cravat about one of the shoul- 
fig. 71. ders, the left for example, as at a. 

Now place the center of the other 
cravat in front of the opposite 
axilla (the right in this case), and 
carry one end up over the same 
shoulder (the right) and the other 
beneath the same axilla, to the 
back. Carry, now, the superior 
extremity through the noose form- 
ed by the cravat first applied ; then 
twist the other extremity about 
this one, as at b and c, and finally 
tie, as at d. 

Uses. — The same as the Simple Dorsal Biaxillary Cravat, and 
the Posterior Figure of 8 of the Shoulders. This is a very powerful 
bandage, and the arm-pits need to be well padded. 

Variety. — Take three cravats, two of them being, each, about 
two feet in length, the remaining one something short of this. Tie 
one about each shoulder. Then tie the third one through the nooses 
formed by the first two, so as to bring the two together at the back, 
thus taking the place of the single noose, b, c, d, of the preceding 
cut. If there is danger of either of these bandages slipping from the 
shoulder, a cravat might be tied across the breast, from one to the 
other, similar to that at the back, thus effectually preventing such a 
mischance. 



ANTERIOR FIGURE OF 8 OF THE SHOULDERS. 

(Anterior " Star" Bandage.) 

Description. — This bandage should be eight yards in length 
by two inches in width. 

Application. — Place the initial end, i, at the front of the 



84 



BANDAGES OF THE BODY. 




Anterior Figure of 8 of the Shoulders. 



fig. 72. middle of the right 

arm, and confine by 
two horizontal circular 
turns, 2 and 3. Con- 
tinue on in the same 
course, till you reach 
the posterior surface of 
the arm, when you 
mount up over the 
shoulder of the same 
side and cross diago- 
nally downwards to the 
left axilla, thus finish- 
ing course 4. Pass the roller-head beneath this axilla, and over the 
same shoulder, and diagonally down across the front of the chest to 
the right axilla, thus finishing course 5. Conduct the bandage under 
this (the right) axilla, and then upon the right shoulder, and diago- 
nally down across the front of the breast to the left axilla, thus com- 
pleting course 6. Course 7 is made similarly to course 5 ; course 8, 
to course 6 ; course 9, to course 7, and so on. At last exhaust the 
bandage, and confine either by pinning or stitching. 

Uses. — In cases of fractures of the sternum, or separation of 
the sternal cartilages ; also in cases of burns on the interscapular 
regions, when vicious cicatrization is to be feared. Might be of use 
in some clavicular dislocations. As in all of the axillary bandages, 
this one needs a thorough protection of the axillae by cotton-wool in 
order to prevent chafing of the parts, especially the posterior portion. 



SIMPLE STEENAL BIAJQLLAEY CEAVAT. 

Description. — This bandage is made from a cravat one and 
one-half yards in length. 

Application. — The opposite to that of the Dorsal Cravat, 
described upon*page 82, this one being applied across the chest. 

Uses. — Similar to those for which the preceding is employed. 



MANUAL OF BANDAGING. 85 

COMPOUND STERNAL BIAXILAKY CRAVAT. 

Description. — Two cravats, one one yard in length, the other 
two feet in length. 

Application. — Opposite to that of the Compound Dorsal 
Biaxillary Cravat, described upon page 83. This one being applied 
across the chest. 

Uses.— Same as the Anterior Figure of 8 of the Shoulders. 

Variety. — Prepare three cravats, two of them being two feet in 
length, the third one not quite so long. After tying one of the two- 
feet ones about each shoulder, tie the remaining one into the nooses 
formed by the other two, across the front of the chest. A fourth 
cravat is now necessary to prevent those fastened about the shoulders 
from slipping forwards and off these parts, and is tied to them across 
the back. 



12 



86 BANDAGES OF THE LOWER EXTREMITY. 



CHAPTER IX. 
BANDAGES OF THE LOWER EXTREMITY. 

SPIRAL OF ONE TOE. 

Description. — This should be made from a roller four feet 
in length by three-quarters of an inch in width. 

Application. — This is so similar to that of the Spiral of One 
Finger, described upon page 54, figure 39 that no further discussion 
is necessary. 

Uses. — For injuries of the toes, similar to those of the fingers 
for which the spiral is there used. 

FIGURE OF 8 OF ONE TOE. 
(Spica of the Toe.) 

Description. — This bandage should be made from a roller, 
two yards in length by three-quarters of an inch in width. 

Application. — Similar to that of the Figure of 8 of the Thumb 
and Wrist, or Spica of the Thumb. See figure 40, page 55. 

Uses. — Of a similar use to that of the Spica of the Thumb. 

DOUBLE T OF THE TOES AND ANKLE. 
Description, Application and Uses are so similar to the Double 
f of the Back of the Hand and Wrist, that a reference to it, figures 
42 and 43, pages 57 and 58, will be sufficient for its application to 
the foot. 

SPIRAL OF ALL THE TOES. 

(Gauntlet of the Foot.) 
Description. — This bandage should be ten yards in length by 
three-quarters of an inch in width. 



MANUAL OF BANDAGING. 



87 



Application. — Similar to the Gauntlet of the Hand. See figure 
47, page 61. 

Uses. — Similar to those of the Spiral of All the Fingers, just 
referred to, only in case of diseases or injuries of the foot. 



FIGURE OF 8 OF THE FOOT AND ANKLE. 

Description. — This should be a roller two and a half yards in 
length by one and three-quarter inches in width. 

Application. — Place the initial end, i, at the front of the leg, 
a few fingers' breadth above the ankle, 
and confine it by the horizontal circular 
turn, 2. Continue on in the same course 
till you come to the inner malleolus 
again, supposing it to be the left foot 
that you are dressing, when you descend 
obliquely across the dorsum of the foot 
to the fifth metatarsus, thus completing 
course 3. Make, then, a circular turn 
about the metatarsal bones (course 4), 
coming obliquely across the dorsum of 
the foot, from within outwards, to the 
outer malleolus, thus completing course 
5. Course 6 is made similarly to course 
3, course 7 to course 5, and so on. At 
last exhaust the bandage by circular 
turns about the lower portion of the leg, and confine in the ordinary 
way. 

Uses. — For confining dressings either to the dorsum of the 
foot, or to the surface contiguous to the malleoli. Also for com- 
pression, after venesection from one of the dorsal veins of the foot ; 
a graduated compress would be necessary in this case. 

SPIRAL OF THE FOOT. 

This bandage is but a part of the Spiral of the Inferior Extremi- 
ty, and will be sufficiently described when we come to treat of that 
dressing. 




Figure of 8 of the Foot and 
Ankle. 



88 



BANDAGES OF THE LOWER EXTREMITY. 



TRIANGLE OF THE FOOT. 
Description. — A triangle with a base two feet in length and a 
height of ten inches. 

Application. — Place the base of the triangle obliquely across 
fig. 74. the front of the ankle, a, and carry the 

superior end, b, around the lower part of 
the leg, and confine. Conduct the in- 
ferior extremity about the metatarso- 
phalangeal bones and pin, as at d. Then 
conduct the apex of the bandage about 
the heel, and pin as at c. 

Uses. — To confine dressings either to 
the dorsum or the sole of the foot, to 
either of the malleoli, or regions adjacent, 
or to the calcanean region, or the lower 
part of the leg. 




Triangle of the Foot. 



FOUR-TAILED BANDAGE OF THE INSTEP. 

(Sling of the Instep.) 

Description.— This should be a strip of cloth, eighteen inches 
in length, and four inches, or more, in width, cut to a four-tailed 
bandage, as seen in the compress of four heads (figure 4). 

Application. — Place the centre of the bandage at the instep, 
and carry the two superior ends around the lower part of the leg 
and tie them ; then carry the two inferior ends around the tarsal 
portion of the foot, and tie also. 

Uses. — To confine cataplasmata, and other dressings, to the 
instep, lower front portion of the leg, and the tarsus. 



FOUR-TAILED BANDAGE OF THE HEEL. 

(Sling of the Heel.) 

Description. — This should be eighteen inches in length and 
four or more in width, and torn to a four-tailed bandage. 

Application. — Place the body. of the bandage at the heel and 



MANUAL OF BANDAGING. 



39 



carry the two superior ends around the lower portion of the leg, and 
confine. The two inferior ends are then to be carried about the 
tarsus, and also tied. 

Uses. — To confine dressings to the calcanean region. 



SHEATH OF THE FOOT. 
Instead of the more elaborate bandage proposed by some 
surgeons, an equally efficacious bandage, and certainly easier 
obtained, is a common "stocking." Is used as a retainer of 
cataplasmata to the toes or foot. 



POSTERIOR FIGURE OF 8 OF THE KNEE. 
Description. — The roller should be four yards in length by 

one and three-quarter inches in width. 

fig. 75. Application. — Placing the initial end 

of the bandage, i, at a point somewhat 
above the popliteal space, confine it by 
a horizontal turn of the bandage, 2. Con- 
tinue on in the same direction, passing 
over the front of the thigh, till you come 
nearly to the posterior surface again, where 
you descend, obliquely, across the popliteal 
space to the opposite border, thus finishing 
course 3. Course 4 is a horizontal turn 
about the upper part of the leg; while 
course 5 ascends obliquely across the pop- 
liteal space to the opposite lateral border. 

Course 6 is in line of course 3 ; course 7, of course 5, and so on. 

Having exhausted the bandage, after covering in the popliteal space, 

confine in the ordinary way. 

Uses.- -To confine dressings to the popliteal space ; or, with 

the aid of a graduated compress, to exercise compression upon an 

aneurism at this point. 




Posterior Figure of 8 of 
the Knee. 



90 



BANDAGES OF THE LOWER EXTREMITY 



THE POPLITEAL CKAVAT. 

Description. — A cravat some four feet in length. 

Application. — Place the centre of the cravat, a, at a point just 
fig. 76. above the popliteal space, and carry the two 

ends horizontally forwards about the thigh ; 
cross them, and descend obliquely across the 
space, b, b', crossing one above the other 
there ; carry them now horizontally forwards 
about the upper portion of the leg, crossing 
them below the patella, to conduct them to 
the posterior surface of the leg, confining by 
tying, as at c. 




The Popliteal Cravat. 



Uses. — This bandage fulfils the same in- 
dications as the above. 



ANTEEIOE FIGUKE OF 8 OF THE KNEE. 

Description. — A roller, four yards in length by one and three- 
quarter inches in width. 

Application. — Essentially the same as that of the Posterior 
Figure of 8 described upon page 89, only remembering that it is to 
the anterior surface of the limb that you are applying the bandage. 

Uses. — To aid in supporting the patella, when fractured ; to 
compress an effusion into the joint, and confine various dressings 
thereon. 



CKAVAT OF THE KNEE. 

Description. — A cravat some four feet in length. 

Application.-— Place the centre of the cravat, a, see figure 
76, page 90, above the patella, and carry the two extremities back- 
wards and cross them, and so bring diagonally down across the front 
of the patella, in a measure similar to that seen in The Popliteal 
Cravat just referred to The other courses of the bandage are made 
similarly to the corresponding courses of this popliteal dressing. 

Uses. — As an approximator of the fragments of a fractured 
patella, and for " steadying " the motions of the joint, or confining 
loose dressings thereon. 



MANUAL OF BANDAGING. 



91 



TESTUDO OF THE KNEE. 



(Roller Cap of the Knee.) 




Description. — A roller eight feet in length by one and three- 
quarter inches in width. 

Application. — Place the initial end of the bandage, i, below 
fig. 77. the patella, and confine by a single circu- 

lar turn, 2. Continue on in the same 
course with the bandage, making an as- 
cending spiral course for turn 3. The rol- 
ler-head is now carried upwards across 
the popliteal space, above the femuric 
condyles, and made to take the descend- 
ing spiral course 4, to finish this turn of 
the bandage. It is then carried down- 
wards across the popliteal space, so as to 
be in readiness to make the ascending 
spiral course 5. Course 6 is made simi- 
larly to course 4 ; course 7, to course 5, 
and so on, gradually " drawing in" the bandage till the patella is 
entirely covered, when you either confine, or else go on to finish the 
bandage as a spiral of the thigh. 

Uses. — To confine dressings about the knee-joint, to exercise 
compression thereon in cases of synovitis, or to steady the joint and 
prevent motion in cases of other injuries of the leg. Is frequently 
made use of in the Spiral of the Inferior Extremity when covering 
in the knee-joint. 

Variety. — Instead of the alternate upward and downward spiral 
courses being used, a bandage, fulfilling the indications of the above, 
may be made by the use of continued ascending spirals about the 
member. This is the form most generally made use of in applying 
the Spiral of the Inferior Extremity, and is seen in the figure of 
that bandage on a following page. It is known as The Spiral of the 
Knee. 



Testudo of the Knee. 



FIG. 78. 



92 BANDAGES OF THE LOWER EXTREMITY. 

FOUR-TAILED BANDAGE OF THE KNEE. 

Description. — A strip of linen or cotton, from eight to ten 
inches in width, and one yard in length. Each end to be torn back 
(at its centre) to within eight inches of the middle of the bandage. 

Application. — Place the plane of the 
bandage, a, over the patella, and carry the 
superior ends of the bandage around the 
lower part of the thigh, crossing them to 
remount the member, b, to tie in front. Then 
conduct the two inferior extremities in a 
similar manner about the upper portion of. 
the leg, d, to finally confine by tying below 
the patella. 

Uses. — To confine cataplasmata or 
vesicants upon the patellar region. It can 
also be made use of to approximate the 
patellar fragments, when the bone is frac- 
tured, or, with the aid of compresses, to exercise compression, in 
cases of chronic synovitis. 




Four-tailed Bandage of 
the Knee. 



SIMPLE SPIRAL OF THE LEG. 

Description. — This bandage is made from a roller four yards 
in length by two inches in width. 

Application. — Beginning at the ankle, make a simple circular 
turn about the member, thus confining the initial end of the band- 
age. Then continue the turns of the bandage spirally about the 
member (omitting the reverses) as seen in turns 15, 1 6 and 17 of 
the figure accompanying the Spiral of the Inferior Extremity. At 
last confine as usual. 

Uses. — For maintaining pressure upon the parts covered, or for 
retaining dressings thereon. Is not a very stable bandage should 
the musculi gastrocnemius et soleus be well developed. 

Variety. — This bandage may be applied to the thigh ; it then 
becomes The Simple Spiral of the Thigh. The starting point, in this 
case, being at the knee. 



MANUAL OF BANDAGING. 



93 



REVERSED SPIRAL OF THE LEG. 

Description. — A roller eight feet in length by two inches in 
width. 

Application.— This is but a part of the bandage described 
under the head of The Reversed Spiral of the Inferior Extremity, and 
will be sufficiently described when treating of that bandage. See 
figure on page 96. 

Uses. — This makes a very stable sort of dressing, and is to be 
employed, in most cases, in preference to the preceding bandage, 
as it is not so liable to slip down and out of place. 

Variety. — This bandage may be equally well applied upon the 
thigh, starting at the knee. It is then known as Ihe Reversed Spiral 
of the Thigh. 



THE FIGURE OF 8 SPIRAL OF THE EXTREMITIES. 



Description.- -This bandage is a double spiral, and needs for 
its application a roller bandage ten yards in length by two inches in 
width. 

Application.- -Place the initial end at the roots of the toes, 
fig. 79. confining by a single spiral turn about 

the foot, and cover the foot as in the 
Spiral of the Inferior Extremity, by rever- 
ses and figures-of-8. Having reached the 
leg, one turn and a half is made before a 
reverse is used. Thus the reverse is 
employed on the second turn of an ordi- 
nary spiral instead of upon the first, as in 
the simple spiral with reverses. This 
process of reversing upon each second 
turn from the last reversement is pursued 
up the entire limb. Hence, course 9 is 
a simple spiral, whilst course 10 is a 
spiral with a reverse. Course 1 1 is com- 
pleted as an upward spiral about the limb, with no reverse, whilst 
13 




The Figure of 8 Spiral of the 
Extremities. 



94 



BANDAGES OF THE LOWER EXTREMITY 



course 12 would be a reversed spiral, coming from above down- 
wards, across the front of the limb. Course 13 is similar to course 
11 ; course 14, to course 12, and so on until the bandage is exhaust- 
ed. This makes, then, a Figure of 8 Spiral of the Extremities with 
alternate reverses. 

Uses. — Similar to those for which the Simple and the Reversed 
Spirals are employed, and may be used on either the upper or lower 
extremity. It makes a very secure method of dressing, and gains 
this advantage through this fact : that the superficial courses (the 
reversed ones) rest upon cloth, and not upon the slippery integument, 
as in the case of the other bandages. The same advantage might 
be gained by covering an ordinary spiral with a second bandage, — 
an ordinary Reversed Spiral. 

This variety of the spiral bandages is especially useful in plaster- 
of- Paris, starch, or other so-called immovable dressings ; also in 
fractures, or other cases where extension is demanded, and where a 
long interim between dressings is desirable. 

Variety. — If the bandage is composed of very extensible mate- 
fig. 80 rial, as very thinly woven flannel, so as to 

be easily "moulded to apart," it may 
be made throughout without a si?igle 
reverse. Each course of the bandage 
would then be a single figure of 8 about 
the limb; thus, turns 7 and 8 would be 
simple circles of the limb ; turn 9, an 
upward spiral, turn 1 o, a downward spiral 
turn n, an upward spiral again, overlap- 
ping turn 9; turn 12, a downward spiral, 
overlapping turn 10, and so on until the 
limb is sufficiently encompassed. 

This also makes quite a firm dressing, 
as the superficial courses of the bandage rest upon flannel, and not 
upon the integument. It is used in cases similar to the preceding. 
It is known as the Figure of '8 Bandage of the Extremities > and can 
be applied, as its name indicates, to either the inferior or superior, 
extremities. 




Figure of 8 Bandage of the 
Extremities. 



MANUAL OF BANDAGING. 



96 



TRIANGLE OF THE LEG. 



Description. — A triangle one yard in length at the base, and 
eighteen inches in height. 

Application. —Place the base of the triangle, a, obliquely 
FIG - 81 - across the front of the leg, and carry the 

superior extremity around below the patella, 
and confine with a pin, b. Then conduct 
the inferior extremity around the lower part 
of the leg, and also confine it, c. Then 
carry the apex of the triangle around the 
"calf" of the leg, also confining it with a 
pin, as at d. 

Uses.— Useful in confining dressings to 
the parts it covers, and also for maintaining 
compression, when this may be required. 

Variety. — This bandage may be ap- 
plied to any part of the leg, or even to the 
arm and forearm, fulfilling similar indications in diseases or injuries 
of those parts. 




FOUR-TAILED BAND.VGE OF THE LEG. 

Description. — A piece of cloth wide enough to sufficiently 
cover the diseased portion of the member. This is then to be cut 
back, at the ends, to' near its centre, as you see in the compress 
(figure 4), upon page 17. 

Application. — The plane of the bandage is to be placed over 
the calf of the leg, and the two superior ends carried forwards, and 
around the leg, below the patella, and confined. The two inferior 
ends are then to be conducted about the lower portion of the leg, 
and also confined by tying, 

Uses. — To confine cataplasmata, or other dressings, upon the 
gastrocnemial and soleal region. 



96 



BANDAGES OF THE LOWER EXTREMITY. 



KEVEKSED SPIRAL OF THE INFERIOR EXTREMITY. 



Description. — This bandage is made from a roller eighteen 
yards in length by two inches in width. 

Application. — Place the initial end of the bandage at the 
metatarso-phalangeal articulation, and confine 
by two circular turns about the foot at this 
point. Continue on about the foot in the same 
manner, only making a reverse at each course 
of the bandage, until the ankle is reached, as 
you see in the wood-cut. Or, it is sometimes 
best to make the last two or three turns about 
the foot and ankle in figure-of-8's, as you see 
in wood-cut number 73, page 87. It is also 
often necessary to fill up the hollows about the 
ankles with cotton-wool. Having got so far 
in the application of the bandage, make three 
or four spiral turns about the lower part of the 
leg, courses 15, 16, 17, 18 in the figure, before 
you begin the reverses about the leg, — courses 
19 to 30 inclusive; you then come to the 
knee, which may be covered in by The Testudo, 
figure 77, page 91, or the simple spiral turns, 
3 T > 3 2 , 33, 34 and 35 in the cut. Having 
' cleared the femuric condyles, you then make spiral reverses to the 
hip; where you confine the bandage in the usual way. 

Uses. — For all the multitudinous purposes such an injured or 
diseased member may demand. The same caution should be observed 
here as was spoken of under the Reversed Spiral of the Superior 
Extremity, page 65. 




Reversed Spiral of the 
Inferior Extremity. 



RECURRENT FOR AMPUTATED THIGH. 

Description. — This bandage should be twelve yards in length 
by one and three-quarter inches in width. 






MANUAL OF BANDAGING. 



Application. — Place the initial end, i, upon the front of the 
fig. 83. thigh, and confine by three horizontal 

circular turns, 2, 3 and 4. Continue the 
course of the bandage about the limb, 
horizontally, finishing turn 5 at the lateral 
border of the member. Reverse the 
bandage at right angles, and continue 
course 6 down the limb, across the 




stump, then up to the fourth course of 
the bandage, thus finishing turn 6. Re- 
verse, now, the bandage at right angles 
again, and encircle the member for turn 
7, finishing it, anteriorly, at the middle 

of the limb, as course 8. Continue the 

Recurrent for Amputated Thigh. , , _ ,, r • , 

bandage on in the same course to finish 

turn 9 upon the member's anterior surface. Again you reverse at 
right angles, and carry the bandage longitudinally down the limb 
and across the stump, thus making the tenth course of the bandage. 
The remaining courses of the bandage are applied similarly to those 
just described. At last, when the -stump is covered, and the band- 
age exhausted, confine in the usual way, by pinning. 

Uses. — For confining dressings to a " stump." Is somewhat 
" tedious " of application, and hence the two following bandages are 
to be preferred to it. 

Variety. — This bandage is equally applicable for any stump of 
the leg, or of the upper extremity. It would then be of the same 
width, but somewhat shorter. It would then be known (from its 
respective uses) as The Recurrent for an Amputated Leg; The Recur- 
rent for an Amputated Forearm ; The Recurrent for an Amputated 
Arm. A somewhat similar Recurrent has been devised for a hip- 
joint stump, and also for a shoulder-joint stump. The same objec- 
tion holds good against these bandages, as the one just described ; 
viz.: rather more ornate than useful. 



BANDAGES OF THE LOWER EXTREMITY. 



TRIANGLE FOR THIGH STUMP. 

Description. — This should be a triangle having a base one 
yard in length, and a height of eighteen inches. 

Application. — Place the middle of the base of the triangle, a, 
FIG - 84 - upon the anterior surface of the thigh, 

at a proper distance from the cut sur- 
face ; carry the two extremities back- 
wards about the member, and bring them 
forwards, after crossing them, to pin at 
the front, b and c. Carry, then, the apex 
of the triangle directly across the stump 
and up the posterior surface of the limb, 
pinning to the crossed extremities b and c. 
Uses. — This is a very convenient 
bandage for protecting a stuhip from in- 
jury from clothing and the like, and also for confining cataplasmata. 
Variety. — By varying the size of the triangle, it can be made 
to answer for any stump of either the upper or lower extremity. It 
would then be known as The Triangle for Leg Stump, The Triangle 
for Arm Stump, etc., according to the part upon which it might be 
applied. 




Triangle for Thigh Stump. 



MALTESE-CROSS FOR THIGH STUMP. 

Description. — I. A piece of lint, or cloth, sixteen inches 
square, cut to the form of a Maltese cross, see figure 7, page 20. 
II. A roller two yards in length, by two inches in width. 

no. 85. Application. — Place the centre of the 

cross, a, over the centre of the stump, 
and fold the edges over each other, b 
and c, as you see in the wood-cut, so 
that they -may lie as smoothly as pos- 
sible. Then confine with the roller by 
the use of circular turns about the limb, 
using reverses, if need be. 

Uses. — Similar to the Stump-triangle, 
Maltese-cross for Thigh stump. an( j e q Ua Uy useful and easy of application. 




MANUAL OF BANDAGING. 



op 



Variety. — By varying the size of the cross, and the roller, 
this bandage is equally applicable for any stump of either extremity. 
It makes most an excellent dressing for hip or shoulder-joint 
stumps. It would then be The Maltese-cross for Leg Stump, The 
Maltese-cross for Arm Stump, etc., according to the uses for which 
it is employed. 



CAPUTINA. 

(Rosette Stump Dressing.) 

Description. — Take from nine to fifteen strips of cloth 
(according to the size of the stump), having each one one and three- 
quarter inches in width, by two and a-half feet in length. 

no. 86. These strips are to be 

placed in two groups. One 
set should be so arranged as 
to form a half rosette, a, 
whilst the others should be ar- 
ranged in a parallel group, 
b, each strip slightly overlap- 
ping its fellow. The half- 
rosette, including one strip 
parallel with the second set, 
is made secure with a pin, or 
stitches, at the point of radi- 
ation of the different pieces, 
called its center, as a. The 
horizontal strips of parallels 
may now be stitched together 
at their centers, though this 
is not necessary. The whole 
bandage is then spread upon a newspaper. The horizontal strip, c, 
of the rosette is laid upon the first piece of the parallel strips (so 
that the set of parallels becomes but an extension of the rosette), 




Diagram of the Caputina. 



100 



BANDAGES OF THE LOWER EXTREMITY. 



and fastened to it. The object of spreading it upon the paper is 
only for convenience in carrying and handling. 

Application. — The stump is now made ready for this final 
fig. 87. bandage. The centre, a, figure 86, is 

placed opposite the median line of the 
under surface of the stump, at a point 
some six inches from its end, and con- 
fined there by the long cross strip, c- 
c, which encircles the member. The 
remaining portions of the rosette are 
thenla id, smoothly and successively, 
over the stump, covering the end com- 
pletely. The bandage is then finished 
by passing the horizontal parallel strips, 
b, over the remaining portion of the 
limb, securing the free ends of the ro- 
sette that are folded over its anterior 
surface, thus completing the dressing 
which is represented, as applied to a 
thigh-stump, in figure 87. 
These parallel strips may be used more or less extensively upon 
the limb, as the exigencies of the case may seem to demand. This 
bandage is really but the extension of the principle of that of 
Scultet's, the whole upper portion, b, figure 86, being but the bandage 
of Scultet. 

Uses. — This bandage is used only in the dressing of stumps ; 
and it is particularly valuable where pressure is required, — as when 
the flaps retract, making the wound gape, and thus leaving the bone 
exposed. In its application the stump needs be lifted but once, i. c, 
when the bandage, lying upon the paper, is first slipped under — a 
desideratum wanting in all other stump-dressings. 




Caputina applied. 



TARSO-PATELLAR CRAVAT. 



Description. — I. Two cravats, each one one yard in length. 
II. A third cravat one-half the length of the others. 



MANUAL OF BANDAGINO. 



101 



Application. — Tie the smallest of the cravats about the instep, 
fig. 88. as a. Take, then, one of the re- 

maining, place its centre, b, above 
the patella, and carry both ends 
backwards around the lower portion 
of the thigh, crossing them at the 
back, and bringing them diagonally 
downwards and forwards, below the 
patella, there tying. Take, then, the 
third cravat and carry it through, to 
its centre, c, the " stirrup " formed 
by the one first applied, a, and con- 
duct each extremity, one upon each 
side of the .leg, up and under the 
loops of the one applied at the pa- 
tella, b. Flex the foot, to a sufficient 
degree, upon the leg, and then 
fasten the cravat last applied by 
pinning the extremities. 
Uses.— Mayor proposed this bandage for cases of knee-pan 
fractures. It is more suitable in cases of the rupture of the ligamentum 
patellae, in transverse wounds of the instep, and in cases of talipes 
equinus, where extension of the tendon Achillis is required; or, 
after its division, to properly place the foot that it may overcome 
this deformity. 




Tarso-patellar Cravat. 



TARSO-CRURAL CRAVAT. 



Description. — I. Two cravats, each one one yard in length. 

II. A third cravat eighteen inches in length. 

Application. — So similar to that of the preceding that no 
wood-cut is necessary ; the only difference being that the second one 
(b, in the preceding figure) is to be applied about the upper portion 
of the thigh, and to this the long cravat c (of the preceding cut) is 
to be fastened, after it has been passed through the cravat-stirrup, a, 
about the foot. 
14 



102 



BANDAGES OF THE LOWER EXTREMITY 



Uses. — The mechanism of this bandage is to forcibly flex the 
foot, and at the same time the leg, upon the thigh; and hence is use- 
ful in cases of rupture of the soleus or gastrocnemius muscles, or 
their common tendon, and in transverse wounds of the back of the 
heel or leg. 

Variety. — Tarso-pelvic Cravat. The only difference here being 
that the cravat is tied about the pelvis instead of about the upper 
portion of the thigh. The uses are identical to those of the Talo- 
crural. 



SCAPULO-TIBIAL TRIANGLE AND CRAVAT. 

(Sling for the Inferior Extremity.) 

Description. — I. A cravat, or scarf, two yards in length. 

II. A triangle whose base mea- 
sures one and one-half yards, and 
whose height is two feet. 

Application. — Tie the scarf 
over the shoulder opposite the 
injured leg, as a. Place the base 
of the triangle, near its middle, at 
the anterior surface of the leg, b, and 
carry the two ends upwards and tie 
into the" "sling" formed by the 
cravat. Then pin the apex of the 
triangle at the outer side of the 
leg, to the base of the triangle, as 
at c ; folding it across the front of 
the knee, so as to prevent the mem- 
ber slipping too far forwards, and 
out of its support. 




Scapulo-tibial Triangle and Cravat. 



Uses. — To support either lower 
extremity, when injured ; or to hold 
moderately flexed the leg upon the thigh. Is a very convenient 
and useful dressing. 



MANUAL OF BANDAGING. 



103 



fig. 90. 



SLING OF THE LOWER EXTREMITY. 

Description.- — A cravat long enough to reach from the neck to 
the foot, and back again, to tie about it. 
It is also made from webbing, with a 
buckle attached, as represented in the cut. 
Application. — The limb having 
been properly bandaged, the cravat or 
webbing, at its centre, is to be passed 
underneath the foot, and then tied about 
the neck. 

Uses. — As a support, merely, of an 
injured foot, leg, knee, or thigh, when 
walking with crutches is allowable. 

CROSS OF THE GROIN. 

(Ascending Spica of the Groin.) 

Description. — This should be made 
from a roller nine yards in length by two 




Sling of the Lower Extremity. 



inches in width. 



Application. — Place the initial end of the bandage at the 
FIG 91 front of the abdomen, i, and 

confine by the two horizontal 
circular turns 2 and 3. Con- 
tinue on in the same course till 
you come to the ilium of the 
injured side, when you descend 
obliquely across the inguinal 
region, passing down between 
the thighs, thus completing the 
fourth course of the bandage. 
You then encircle the thigh of 
the same side, and, on coming 
to its anterior surface, ascend 
obliquely across the inguinal re- 
gion, from without inwards, upon 
the abdomen, to the opposite side of the body, thus completing the 




Cross of the Groin. 



104 BANDAGES OF THE LOWER EXTREMITY. 

fifth course. Course 6 is made similarly to course 4 ; course 7, to 
course 5 ; course 8, to course 6 ; course 9, to course 7 ; and so on 
until the roller is nearly exhausted, when you make one or two 
horizontal turns about the abdomen, and confine. 

Uses. — For maintaining dressings upon the inguinal region; 
also for making compression upon any of the enlarged glands in this 
neighborhood, and for maintaining a replaced herniae. 

Variety. — Descending Spica of the Groin. This differs from 
the preceding only in having the courses of the bandage across the 
groin run from above downwards ; that is, course 4 of the bandage 
is put in the line of course 16; course 5, in the line of course 17 ; 
course 7, in the line of course 15, and so on. 



TEAPEZOIDAL J OF THE GKOIN. 

Description. — I. A piece of cloth, cut to the shape of a 
trapezoid, sufficiently large to cover the groin. 

II. To one of the angles of the base of this trapezoid, the 
external superior (as a in the following figure), stitch a small roller, 
two yards in length by one and three-quarter inches in width. 

III. To the other extremity of the base, b, stitch another roller 
of the same width, but three yards in length. 

IV. Across the apex of the trapezoid stitch another roller, 
having the same width, but being two feet in length, as at c. 

Application. — Place the base, a-b, of the trapezoid above the 
fig. 92. injured groin, and encircle the 

abdomen with the roller a, as a'. 
Conduct the roller b across the 
crest of the opposite ilium, then 
diagonally downwards across the 
sacrum and nates to a point 
considerably below the great 
trochanter, and then obliquely 
upwards across the trapezoid, as 
b', and the abdomen, to pass 
around the back again, and tie 
with the portion a at the side. 
Trapezoidal T of the Groin. pi n the portion b' to the trape- 




MANUAL OF BANDAGING. 



10.-, 



zoidal piece of lint, and also to the roller-turn a'. This done, en- 
circle the thigh with the roller from the inferior portion of the 
trapezoid, as at c, confining it with a pin. 

Uses. — For maintaining cataplasmata and other dressings to the 
groin and anterior surface of the thigh, when the patient is kept in 
the recumbent posture. Is of little or no value in exercising com- 
pression, and hence does not, in this particular, take the place of 
the Spica of the Groin just described. 



CRUKO-INGUINAL TRIANGLE. 

Description. — A triangle one yard in length across its base, 
and some eighteen inches in height. 

Application — Place the base of the triangle, a, just above and 
fig. 93. to the inside of the anterior spine of 

the ilium, the right for example, in an 
oblique manner ; carry, then, the in- 
ternal (inferior), extremity about the 
injured thigh, from within outwards, 
and pin, as at b. Then conduct the 
other extremity around the body, 
bringing it forwards and obliquely 
downwards across the opposite inguinal 
region, c, and pin to the base of the 
triangle. The apex is then to be car- 
ried backwards and downwards across 

the gluteal region of the injured side, and confined as usual. 

Uses. — This bandage of Mayor's is very useful in confining 

dressings to one of the nates, upper part of the thigh, or one of the 

inguinal regions. 

Variety. — The Cruro-pelvic Triangle is made, essentially, in the 

same manner ; the only difference being that the base of the triangle 

is applied farther up upon the abdomen, thus adapting it more 

especially for confining dressings about the crest of the ilium, and 

the lower lateral portion of the abdomen. 




106 



BANDAGES OF THE LOWER EXTREMITY. 



Description. - 

pig. 94. 



CRURO-PELVIC CRAVAT. 

(Inguinal Cravat.) 
-A wide cravat one yard in length. 

Application. — Place the mid- 
dle of the cravat at the pubic 
region, as a, carry, then, the su- 
perior extremity, or the one to the 
opposite of the diseased side, 
obliquely up across the opposite 
inguinal region, over the iliac crest, 
and around the back ; then con- 
duct the other extremity about the 
thigh of the injured side, as b, 
mounting up across this inguinal 
region, and at last tie with the 

other extremity at the side, as at c. 

Uses. — For confining dressings upon the supra-pubic, inguinal, 

and lower gluteal regions. 




Cruro-peMc Cravat. 



SACRO-BICRURAL CRAVAT. 

Description. — Two cravats, each four feet in length. Tie 
them together at one of their extremities. 

fig. 95. Application. — Place their 

point of tying at the lumbo-sacral 
region, bringing both free extrem- 
ities, a and b, forwards and down- 
wards across the inguinal regions, 
one upon each side ; then pass them 
in between and around the thighs, 
and conduct them obliquely up- 
wards and across the ilio-pubic 
regions, a' and b', to confine them 

Sacro-bicrural Cravat. there with pins. 

Uses. — For confining dressings upon both groins, as in cases of 
bilateral buboes. 




MANUAL OF BANDAGING. 



107 



fig. 96. 



DOUBLE J OF THE PERINEUM. 

Description.- -I. A broad band, long enough to encircle the 
body. 

II. Two strips, each one yard in length by two inches in width, 
sewed at right angles to the broad band, one inch from each other, 
at its central portion. 

Application. — Place the cen- 
tre of the broad band at the 
lumbo-sacral articulation, and con- 
fine it about the body, as at a. 
Bring forwards, between the 
thighs, each of the other strips, 
and pin them to the broad portion 
of the bandage, as at b and c. 

Uses.— To maintain dressings 
upon the sacrum, anus, perinseum, 
and vulva. 

Variety. — Simple T of thePeri- 
nccum. This differs from the above only in having a single perinaeal 
strip. Is used for the same purposes for which the Double T is 
employed. 




Double T of the Perinteum. 



PERINEAL CRAVAT. 



Description. — I. A broad bandage to encircle the abdomen, 
as in figure 96. 

II. A cravat two feet in length. 

Application. — Having applied the abdominal band, as in the 
preceding cut, a, pin (or button) one end of the cravat to the 
sacral portion of the broad band ; pass the other extremity between 
the thighs, and pin at the pubic portion of the band. 

Uses. — Similar to the " T Bandages of the Perinaeum." Ladies 
make use of this cravat for protecting themselves against the 
menstrual flow. 



108 



BANDAGES OF THE LOWER EXTREMITY. 



FIG. 97. 



SACKO-PUBIC TKIANGLE. 

Description. — This should be a triangle one yard in length, 
by eighteen inches in height. 

Application. — Place the base 
of the triangle, a, at the lumbo- 
sacral region, with the apex down- 
wards, and carry the two extremi- 
ties forwards around the body, 
tying, or pinning, at the front. 
Then carry the apex, b, of the tri- 
angle forwards between the thighs, 
and pin, at the pubes, to the tied 
extremities. 

Uses. — To retain dressings up- 
Sacro-pubic Triangle. n the sacral and lower lumbar 

region, the perinseum, vulva and anus. 




FOUK-TAILED BANDAGE OF THE HIP. 

Description. — A piece of cloth one yard in length, by eight 
inches in width, torn to a four-tailed bandage ; see figure 4, page 17. 

Applciation. — Place the plane of the bandage over the dis- 
eased hip, and carry the two superior ends around the pelvic brim, 
and confine by tying. Then conduct the two inferior extremities 
about the upper portion of the thigh, of the side diseased, and 
fasten as usual. 

Uses. — To confine cataplasmata and similar dressings, to the 
parts it covers. 



COXO-PELVIC TKIANGLE. 

( Triangular Bonnet of the Nates. ) * 

Description. — I. A cravat four feet in length. 
II. A triangle having a base one yard in length and a height of 
eighteen inches. 



MANUAL OF BANDAGING. 



109 



fig. 98. 



Application. — Encircle the 
lower portion of the abdomen with 
the cravat d, and confine by tying. 
Then place the middle of the base 
of the triangle, a, below the great 
trochanter, with the apex upwards ; 
then encircle the thigh with the free 
extremities of the base, and confine 
by tying as at b. This done, carry 
the apex of the triangle upwards, 
and confine it to the cravat, as you 
coxo-pehic Triangle. see in the wood-cut, at c. 

Uses. — To retain soft dressings to the parts it covers. 




LUMBO-SCKOTAL TKIANGLE. 

(Suspensory Bandage of the Scrotum.) 

Description.— I. A cravat sufficiently large to encircle the 
body. 

II. A triangle having a base of fourteen inches and a height of 
ten inches. 

Application. — Tie the cravat, a-a, about the lumbo-hypogastric 
fig. 99. regions. Place the base of the tri- 

angle close up to the pubes, be- 
neath the scrotum, and carry the 
ends, b, b, up over the cravat, then 
down beneath it, and forwards 
again, as you see in the cut, and 
tie in front, as d. Carry the apex 
of the triangle upwards across the 
front of the scrotum, passing be- 
neath the tied extremities, and 
beneath the cravat, and fold down 
Lnmbo-scrotal Triangle. oyer an< j j n front of the cravat> 

confining with a pin. 

Uses. — As a suspensory bandage for the scrotum, and its con- 
tents, and as a retainer of dressings to the parts. 
15 





110 BANDAGES OF THE LOWER EXTREMITY 

BOURSE OF THE SCROTUM. 

Description.— I. A piece of cloth, folded to a double square, 
fig. 100. six or eight inches in size. Cut of the 

folded corners by the dotted lines, a-b, 
and c-d, in figure ioo. It is then to be 
stitched across, from a to b, and from c 
to D. 

II. Around the upper portion of this, 
e-d-e', is to be stitched, at its central 
portion, a roller two inches in width by 
four feet in length. 

III. To each inferior extremity, a and 

Bourse of the Scrotum.. _ > ■" 

a', there is to be stitched a roller one 
inch in width by two feet in length. 

Application. — Place the scrotum in the bourse, and draw the 
penis through the opening left at d, c. Conduct the broad band 
around the body, and confine by tying. The other two strips, that 
are attached to the inferior portion of the bandage, are to be carried 
between the thighs, across the perinseum, and up over the buttocks, 
one upon each side of the body, and confined to the broad band 
that encircles the abdomen. 

Uses.— To retain dressings to the scrotum, or to exercise com- 
pression upon its contents ; but more especially as a suspensory 
bandage. Rubber makes a good substitute for the linen bourse 
when compression is demanded, as proposed by Richard and Nela- 
ton, in cases of voluminous varicoceles and sarcoceles. Nelaton em- 
ployed, in these cases, small tubes caoutchouc vulcanise, and by so 
doing forestalled the American surgeon in a similar use of the capote. 
Compression can also be maintained by the use of adhesive strips, 
which method is fully described in the Chapter upon Strappings. 

DOUBLE J OF THE TRUNK. 

Description. — I. A large, quadrilateral portion of cloth to en- 
circle the abdomen. 

II. Two strips, sufficiently long to pass over the shoulders, to act 
as "suspenders." 






MANUAL OF BANDAGING. 



Ill 



III. Two strips of the same length to be passed across the 
perinaeum. 

Application. — Having encircled the abdomino-lumbar regions 
FIG . 101. with the broad quadrilat- 

eral portion of the bandage, 
pass the two portions, b, 
b', of the bandage from the 
posterior to the anterior 
surface, and confine with 
pins to the main bandage. 
Then, pinning the remain- 
ing two strips to each lum- 
bar region of the broad 
bandage, conduct them for- 
wards, across the perinae- 
um, and upwards to the 
abdomen, there to confine, 
having care to have crossed 
them upon the perinaeum, 

Double T of the Trunk. SQ that the strip fastened 

upon the right of the patient, posteriorly, shall be fastened upon the 
left, anteriorly, etc. 

Uses. — As a dressing after paracentesis abdominis, or eviscer- 
ating wounds. Also, as a retainer of pubic and perinaeal dressings. 

Note. — For the Spiral of the Abdomen, see page 72 ; and for the 
Circular- Quadrilateral of the Abdomen (and the Abdomen and 
Thorax), and the Dor sal Cervico-Sternal Tria?igle, see page 74. 

The uses of these bandages are similar to those for which the 
Double T of the Trunk is employed. 




112 IMMOVABLE DRESSINGS. 



CHAPTER X. 
IMMOVABLE DRESSINGS. 

This variety of surgical dressing has long been known to the 
profession. The Father of Medicine, Hippocrates, was quite con- 
versant with the use of this apparatus, and used it in most of his 
cases of fractures. His teachings upon the subject seem to have 
been lost sight of, however, during the many centuries that have 
followed him, and so the introduction of this style of dressing, during 
our later years, has been accredited to the reviver as a new discovery. 
Resurgam is the epitaph of all things surgical, and the history of the 
succeeding ages is but the unfolding of the truthfulness of the pro- 
phecy. In other words, a modern inventor (so-called) can hardly 
hope to be anything further than a reviver of some forgotten 
principle. 

The stiffening substance made use of by Hippocrates, was wax, 
rosin, and cerate, instead of the plaster-of- Paris, starch, dextrine, 
etc., made use of by the moderns. This was well rubbed into the 
the bandage, and upon each succeeding turn of the applied roller, 
besides being applied to the compresses, packings, and even the 
limb itself. 



THE BAVARIAN PLASTER SPLINT. 

Description. — Take two pieces of Canton flannel, of length 
sufficient for the injured member, and of width sufficient to overlap 
slightly when brought around the limb. Those for the leg would 
resemble the pieces of the leg of a stocking when it is cut vertically. 
The pieces should now be stitched together at the back, one to the 
other, down the median line. 

Application.— Spread the bandage out under the limb, so that 
l he stitched portion will correspond to the back of it ; carry, now, 



MANUAL OF BANDAGING. 



113 




The Bavarian Plaster Splint. 



the upper piece about the limb, and fasten by stitches or pins, as 

you see in the wood-cut, 
figure 1 02, a, a, a. The 
member now being firmly 
held, an assistant mixes 
the plaster-of-Paris with 
about an equal bulk of 
water. This is then poured 
over the limb, when 
it is enwrapped with its 
covering, a a a, and evenly distributed over its surface. The edges 
r B b b of the other piece of flannel are then caught up and brought 
forwards around the limb, and confined by a suitable roller, or by 
straps. The plaster soon hardens, and then the edges of the band- 
age may be trimmed, the portion pinned or sewed can be un- 
fastened, and you have then an excellent splint for a member. The 
stitching at the back plays the office' of a hinge, thus facilitating its 
removal and application. 

Caution. — In this, and all other hard dressings intended to 
remain some time upon the limb, you must guard all unevennesses 
of the member, as the region of joints, etc., with abundant layers of 
cotton-wool, as the bandage is apt to contract slightly after its appli- 
cation, thus engendering gangrene. Generally it is best to wait three 
or four days after simple fractures, as of fibula or tibia, with no dis- 
placements, before the strictly immovable dressing is applied. In 
other cases ten or twelve days is about the usual time recommended 
by authors. 

Uses. — As a support to a dislocated member, fractured bones, 
or separated cartilages ; also in inflammation of joints when " absolute 
rest " is to be sought. 

If there should be any undue swelling of the limb, or over-much 
.pain be caused by the pressure of the bandage, of course it should 
be at once removed. The following rules, from Hippocrates, are 
clear and decisive, and form an excellent guide for the surgeon in 
bandaging, either with the movable or immovable apparatus. 

Quoting from Ilspi dyfxajv, § 5 : " These are the signs if the 
patient has been properly bandaged : if you ask him if the limb feels 



114 IMMOVABLE DRESSINGS. 

tight, he says it does, but moderately so, especially about the seat of 
fracture. And these are the symptoms of a moderately tight band- 
age : for the first day and night the patient fancies the tightness does 
not diminish, but rather increases j on the next day there is a soft 
swelling [cedematous] in the hand, or foot, for this is a sign of mod- 
erate compression ; but at the end of the second day the compres- 
sion should feel less, and by the third day the bandage should seem 
loose. If any of these symptoms be wanting, you may conclude 
that the bandage is slacker than it should be ; or if any of them be 
in excess, you may infer the compression is more than moderate 
[/. e. hurtful]." 



THE COMMON PLASTER DRESSING. 

(Pirogoff's Plaster Bandage.) 

Description and Application. — Having first well padded the 
limb with cotton-wool, envelope it with a flannel roller, neatly, 
evenly, and somewhat tightly. Then make your plaster ready, by 
getting it to the consistency of cream, by adding to it about an equal 
bulk of water (mixing up but one-half a teacup of it at a time); 
into this mixture dip the pieces of muslin (thin) that you have pre- 
pared in suitable strips, and squares, and begin laying them evenly 
around the limb. As soon as the plaster-mixture begins to harden 
in the dish, throw it out and mix up a new batch, continuing the 
application of the muslin strips, as before. You will find strips two 
to four inches in width, and long enough to go one and one-half 
times about the member, the most convenient size for applying, 
except in the region of joints ; here squares, or oblong squares, are 
very serviceable. When you have the whole to the requisite thick- 
ness to furnish efficient support to the member, encase the whole 
dressing with a layer of the gypsum, by pouring a portion upon the 
limb enveloped with plaster-cloths, along its entire length. 

The same cautions should be observed here as in the preceding 
variety, remembering this is & permanent dressing. The limb should 
be kept immovable during the application, and very quiet for some 
time afterwards, so that the plaster may not be cracked whilst 
hardening. After this, if the condition of the patient permits, the 



MANUAL OF BANDAGING. 115 

member can be swung in a " sling," and the patient permitted to 
walk or ride out with little or no danger. 

Uses. — These are similar to those just enumerated under the 
Bavarian bandage. 

It migbt be well to notice that the hardening of the plaster can 
be delayed by the addition of a little stale beer, or size, to the mix- 
ture; or it can be accelerated 'by the addition of sodic chloride (com- 
mon salt), or by using warm water to " wet it up." It is best to 
paint the whole, after it is dry, with an application of glue, varnish or 
albumen, so as to prevent " chipping " of the exterior. This band- 
age is also made of starch. 



STARCH, OK PLASTER, ROLLER. 

Description and Application. — Having a bandage (of the 
required length and width) of some meshy or loosely woven material, 
fill it with the powdered gypsum, or starch, by rubbing it in, and 
then roll up firmly and evenly. Have the limb of your patient pro- 
tected with the cotton-wool, ther dip the roller into water, so that 
it becomes wet throughout, then apply it as you would a common 
" spiral " or reversed bandage to the same member. It quickly 
hardens, and you have then quite a firm casing for your patient's 
limb. It is not so secure or firm as the Starch or Plaster Dressing 
just described, yet is very useful in many cases. 

Varieties. — The roller may be prepared as above, and on each 
succeeding turn of it about the member, it may be freely brushed 
over with the plaster-cream, starch, gluten, silicate of potash, glue, 
or whatever hardening substance is used, as in the method em- 
ployed by Hippocrates when using his compound of rosin, wax, and 
cerate ; at last brush the whole over with a thin layer of the sub- 
stance made use of. 

In all of these " hard " bandages, it is well, a day or two after 
its application, to give the whole a coating of varnish, gluten, or 
gum, in order to prevent the bandage " chipping." 

This form of plaster dressing war introduced by the Dutch 
surgeon Maythysen. 

The Bandage of Scultet has also been made use of to make the 



116 IMMOVABLE DRESSINGS. 

" immovable dressings ; " but it is not secure enough to come into 
general use. It is the parallel strips seen at b, figure 86, page 99, 
and is to be similarly applied. 

The Silica Bandage is now considerably used. It dries more 
readily than the gypsum, and possesses the advantage of being 
soluble in water, hence quite easily removed. 

The Parrafin Bandage of Mr. Tait is recommended for open 
wounds, as it does not absorb the secretions as do the other varieties 
of dressings. The substance is kept melted by having its container 
in hot water. The roller is to be passed through it as it is applied. 



FENESTKATED IMMOVABLE DKESSINGS. 

Description. — Any of the preceding varieties of immovable 
bandages may have openings left in them through which the secre- 
tions may find ready exit. 

It would be well to coat the margins of the fenestra for some 
distance around them with parrafin, so as to prevent the absorbtion 
of the fluids by the dressing. 

If the parrafin should happen to crack, it can be easily mended 
by passing a hot spatula over it. 

Uses. — These are applied in cases of compound fractures, or 
where a suppurating surface would otherwise be covered by the 
dressing. 



MANUAL OF BANDAGING. 117 



CHAPTER XL 

UPON STRAPPINGS. 

In strapping a limb we seek one or more of the. following pur- 
poses : 

I. A " support " to the divided tissues. 

II. A compression of the part so as to favor absorb tion of 
effused materials, or to prevent too exuberant granulation, or herniae. 

III. To gain a fixed point upon the member, so as to be en- 
abled to maintain extension of the same. 

For one, or all of these purposes, the common adhesive plaster 

of the shops (Emplastrum Resinoe) is employed. The formula for 

its preparation, according to the American Pharmacopoeia, is : 

1^. Resin se pulveris, ^ vi ; 

Emplastri Plumbi, § xxxvi. 

This often proves irritating to the skin, from the amount of resin 
it contains, if the plaster is to be long applied. The irritability of 
the plaster may be lessened by using less resin in its making. 

Baynton, to whom the profession is indebted for the introduction 
of the " strapping treatment" of old ulcers, made use of a formula 
containing but six drachms of the rosin to a pound of the lead 
plaster, less than one-half the amount used in the Officinal formula. 

The Dublin College, and also the British Pharmacopoeia, incor- 
porate a small amount of soap in their adhesive plaster, thus engen- 
dering a greater pliability of the dressing. 

The plaster is spread upon heavy muslin, or Canton-flannel, by 
the aid of machinery, and comes to us in rolls of several yards in 
length. The strips we use should always be cut lengthwise from the 
roll; otherwise the cloth will "give," when extension is made upon 
it, thus loosening the plaster from its " hold " upon the member. 
16 



118 STRAPPINGS. 

Generally narrow strips are employed in supporting wounded 
parts, but those from one to two inches in width when compression 
or extension, is desired. 

After the strips have been cut they should be heated by placing 
the back of the plaster to a tin vessel containing hot water, or to the 
stove-pipe, before applying to the limb. They will "take hold" 
much better by so doing. If the part to which they are to be ap- 
plied is hairy, a " clean shave " will be necessary before you can 
make a satisfactory application, and will save much trouble and pain 
when you come to remove them. 

In removing adhesive strips from a wound that is uniting, care 
should be exercised lest you pull the lips of the wound assunder. If 
you support the wound with your finger, and remove each end of the 
strip up to, and not crossing over, the uniting line of the divided 
structures, you will reduce this danger to a minimum. 

The portion of the plaster adhering to the limb, after the strips 
have been removed, is best cleaned off by first rubbing with olive 
oil, vinegar, or turpentine, and then washing away with soap. The 
surgeon's fingers are readily cleansed in the same way. 

Oftentimes you will find the plaster discolored when applied to a 
suppurating member. This is owing to a decomposition of the lead 
in the plaster, due to the action of the secretions upon it. 



FOE THE FOOT AND ANKLE. 

Application. — Having cut your strips one or one and one-half 
fig. 103. inches in width, and of sufficient length to cross 

over the end first applied, as you see in the 
figure, you place the centre of the strip over the 
back of the heel, and bring one end, i, down 
firmly, and somewhat forcibly, to the 5th meta- 
tarso-phalangeal articulation. Then seize the 
opposite end of the strip, and bring it equally 
firmly down over the tarsus, 2, to the 1st meta- 
tarso-phalangeal articulation. The other strips, 
3, 5, and so on, are applied in a similar figure- 
For the Footand Ankle. ofLg manner> having care to overlap each pre- 




MANUAL OF BANDAGING, 



119 



ceding one a portion of its width. You will find you can exercise 
almost any amount of pressure by adhesive strips so laid, and care 
should be used lest you interfere too much with your patient's com- 
fort, and so have to take them off before their therapeutical effect 
may be accomplished. 

Variety. — Any portion of the body, when compression is de- 
sired, is wrapped in a similar figure-of-8 style, ulcerated surfaces 
being included in the strappings. It is really surprising the way 
some chronic (especially varicose) ulcers will improve after a week's 
treatment of good and vigorous strapping, although at the time of 
their application they may be somewhat painful to the patient. 



FOR WOUNDS. 
Application. — Having your strips cut of the requisite length 



fig. 104. 



fig. 105. 





For Superficial Cuts. For Deep Cuts, 

(if the wound be not deep they need not surround the limb, but if 
the cut be to the bone, large enough to a little more than encircle 
the limb), you begin at the bottom of the wound (i, in figures 104 
and 105) to apply them, the lips being held approximated by an 
assistant. The first strip having been applied, you follow in the 
same manner with the remaining ones, having care not to overlay 
either angle of the wound, or to apply them so closely that pus will 
not have a free escape. Some surgeons prefer to suture the lips of 



120 STRAPPINGS. 

the wound, and then apply the plaster-strips between the sutures. 
But if the form of strapping represented in figure 105 be used, sut- 
ures will be rarely needed. 



FOR THE TESTICLE. 

Application. — Having the parts shaven, have your patient 
stand against the edge of a table, or with his back to the wall, 
fig. 106. keeping the legs separated. You then seize 

the diseased testis with your left hand, sep- 
arate it from its fellow, and press it as far as 
possible into the scrotal sac, thus making its 
coverings as tense as may be. A short roller, 
having a width of one-half or three-quarters of 
an inch, is then wound three or four times 
about the upper portion of the scrotum, en- 
croaching somewhat upon the epididymis, as 
1 in the wood-cut, thus confining the testis. 
For the Testicle. This roller is then fastened by a short piece of 

the adhesive plaster. You then pass the strips 2 and 3 (which are 
one-half or three-quarters of an inch in width, and long enough to 
go perpendicularly around the gland), completely around the testis, 
beginning them at, and upon, the previously applied roller, and end- 
ing them there. This should be continued until the whole organ 
has been thus enwrapped. Then, taking long pieces of strapping, 
one-half an inch in width, encircle the gland spirally from the bot- 
tom, 4, 5, to the top, overlapping each preceding turn, finishing 
them over the roller that was first applied. 

Uses. — In chronic enlargements of the testis, or in some cases 
of hydrocele. After a day or two's application the organ will be 
found to have shrunken ; then the dressing is to be removed, and 
reapplied. 

Variety. — See page no, upon the tubes caoutchouc vulcanise of 
Nelaton. The Capote is also made a legitimate use of in these 
cases. In both instances the roller, 1, is to be applied before the 
rest of the dressing. The ring of the capote should rest upon the 
applied roller. 




MANUAL OF BANDAGING. 121 

FOR THE BREAST. 

Description.- -The strips having been cut to a width of one 
and one-half or two inches, and a length of some thirty inches, they 
are ready for 

Application. — The Mamma being supported by an assistant 
you fasten one end of the strip over the spine of the scapula of the 
diseased side, and bring it down under the same axilla, and then 
pass it diagonally upwards across the chest, encroaching upon the 
gland, to and over the opposite shoulder, there ending ; you thus 
follow course 13 of the Cross of One Mamma figured upon page 78. 
The other strips should be applied in a similar manner, only en- 
croaching upon the gland more and more, until the necessary sup- 
port has been given. 

If compression is desired, cross strips can be run diagonally down- 
wards across the chest, from over the shoulder of the diseased side 
to the hepatic region. 

An American surgeon has taken advantage of the expansibility 
of sponge in maintaining compression of the mamma. The sponge 
(a large one) is thoroughly cleansed and impregnated with some 
antiseptic, and then pressed between two flat surfaces until it be- 
comes dry, and as flat as possible. It is then firmly strapped or 
bound upon the breast with some one of the breast bandages which 
have been described, and is gradually made to expand by moistening 
with water, if the secretions from the gland or sore be not sufficient 
for this purpose. 

Uses. — As a support of an inflamed or hypertrophied breast. 
Also, when compression is used, as a therapeutic agent in the treat- 
ment of any of the various forms of abscess that may arise within 
or about the gland. 

FOR EXTENSION OF THE LEO. 

Description. — Two broad and somewhat tapering adhesive 
strips, of a length sufficient to reach from the knee-pan to below the 
foot and tie. 

II. Several narrow strips of the same material to surround the 
limb when the extension strips are applied. 



122 



STRAPPINGS. 



Application. — The broad strip, a-b, is warmed and applied to 
fig. 107. the side of the leg, while its fellow is made 

to do similar service upon the other side of 
the member. The narrow adhesive strips, c 
and d, are then applied spirally about the 
leg, as confiners. The inferior ends, b, of 
the two side strips are then tied together, 
and a wedge of wood, a little longer than the 
foot is wide, is placed within the noose, to 
which the weight is attached. The wood is 
used to prevent the chafing and constriction 
of the foot, which would otherwise occur, 
from the bringing together of the two inferior 
ends of the extending strips, as soon as the 
weight was attached. 

Uses. — In cases of fracture where extension is demanded. 
Also, in chronic arthritis, and for overcoming vicious contractions. 

Variety. — This dressing may be applied to the upper extremity, 
though an occasion rarely calls for its use there. 




For Extension of the Leg. 



MANUAL OF BANDAGING. 



123 



CHAPTER XII. 



KNOTS, 



Ligatures were introduced to the profession by Ambroise Pare. 
Previous to his time the " actual cautery," or the cautery of boiling 
oil, was made use of for arresting haemorrhage. Ligatures are con- 
fined by knotting their extremities closely down upon the divided 
vessel they surround. Various styles of knots are employed, though 
we shall limit ourselves to a description of but three. 

THE SURGEON'S KNOT. 

Description. — This is formed by passing one extremity twice 
about the other, in making the noose ; and hence makes a more bulky 
knot. Sometimes the first knot of a ligature is the common single 
knot, and then the Surgeon's knot is made, thus securing it. The 
objection to this knot is its bulkiness, though it is in quite common 
use with some operators. 



FIG. 108. 



THE REEF KNOT. 
Description. — This is the ligature knot in general use among 
surgeons for arresting haemorrhage. 

A " Granny " knot, b, is quite 
frequently made for the -Reef, a, 
through inattentiveness of the 
surgeon ; and students almost in- 
variably make it on their first 
trial of the Reef. It is not a 
really bad knot ; yet it lacks the 
firmness and surety of the Reef. 
The Reef and "Granny" Knots. The Reef knot, a, is made by 

first crossing the ends of the ligature so that the one held by the 
right hand shall be uppermost. You then pass the right extremity 




124 KNOTS. 

around that held in the left hand, from within outwards ; this makes 
the first knot, which is pressed firmly down to, and drawn con- 
strictingly around, the vessel, by the fi?iger tips. You then cross the 
ends again, so that the extremity that was held by the right hand, 
when making the first knot, shall still be uppermost, although con- 
signed to the keeping of the left hand. The second knot is then 
made by passing the end now held by the right hand (formerly held 
by the left) around the other extremity, from without inwards, then 
drawing it closely down to its fellow by the finger tips again, thus 
completing the knot as a whole. 

The secret in avoiding the Granny knot, b, is in keeping the 
uppermost end of the first knot still uppermost when making the 
second one. 

In pulling the ends of the ligature, to tighten the knot, always 
have the direction of the force downwards, or towards the vessel. 
You will thus avoid jerking the noose from the vessel should the 
fingers slip from the thread, or the thread break. 

CLOVE-HITCH KNOT. 

Description. — A strong crash towel is about as good as any- 
thing for making this knot. Previous to its application, the part 
over which it is to be applied should be enveloped with a wet piece 
of lint; this serves the double purpose of protecting the limb from 
excoriation, and of preventing the slipping of the knot from off 
the extremity when making traction. 

fig. 109. Application. — Place one of the extremities 

of the towel, or cravat, over the back of the 
forearm, for example, as at i ; pass now the 
other extremity down across the arm, and up 
over (diagonally from below upwards) the one 
first applied, as at 2. Ascend the arm a little 
space, and then make another horizontal turn 
about it, bringing the end up under the course 
2, thus finishing course 3. 

Uses. — For extension of a member during 
ciove-hitch Knot. reduction of a dislocation. More especially 
applied to the superior extremity. 




MANUAL OF BANDAGING. 



125 



M. GEEDY'S EXTENSION KNOT. 
Description. — This knot is executed with a cravat one and 
one-half yards in length ; the length, however, varying, according to 
the purposes for which it is employed. 

Application. — Place the centre of the cravat upon the tendo 
fig. 110. Achillis, just above the ankle joint, having 

the dorsal surface of the foot towards you; 
then bring the two extremities of the cravat 
forwards, crossing them upon the front of the 
tibio-tarsal articulation, 1'; carry the two 
ends downwards to the plantar surface of 
the foot, recrossing them to carry them up, 
2, 2', in front of the malleoli, and under the 
crossed extremities, 1,1'; then bring them 
downwards, as 3, 3', to fasten as required. 

Variety. — Instead of putting the courses 
2, 2', beneath the crossed extremities, 1,1', 
from below upwards, carry them up across 
these courses, and pass them, from above 
downwards, beneath the courses 1,1'; afterwards make a final 
fastening as desired. 

Uses. — For extension of the lower extremity, as in dressing 
fractures ; the counter-extension being made by the perinseal band, 
or inclination of the bed. 




M. Gerdy's Extension Knot. 



17 



126 CA1APLASMATA. 



CHAPTER XIII. 
UPON CATAPLASMATA. 

CATAPLASMA CAKBONIS— ( Charcoal Poultice). 

Formula.* — Take of wood charcoal, in powder, one-half an ounce ; 
bread crumbs, two ounces ; linseed meal, one and one-half ounces ; boiling 
water, ten fluid-ounces. After macerating the bread in the water for ten 
minutes before the fire, mix well, and then gradually add the linseed meal, 
and intimately incorporate this with the mass. To this add one-half the char- 
coal, stirring it well in, and then sprinkle the remaining charcoal upon the 
surface of the cataplasma, when spread. 

The bread is not a necessary ingredient of this poultice, though 
advised by the Pharmacopoeia. It is quite as well if dispensed with, 
and the poultice is so made by most American dressers. 

If the water is taken at the temperature of boiling, as the Phar- 
macopoeia recommends, the poultice, when spread, is generally of as 
sufficiently high temperature as the part can well stand. Should the 
poultice have become cool, however, it should be heated by placing 
upon a stove, hot-air or steam-pipes. 

Uses. — In a general way all poultices have the same use; that 
of retaining warmth and moisture to a part, thus accelerating slough- 
ing and the discharge of inflammatory products ; also that of pro- 
tecting the surface from the air, and changes of temperature. 
Besides these more general uses, each kind may have a specific 
purpose of its own, as in case of the poultice under consideration. 
A charcoal poultice is, in fine, an antiseptic and disinfective poultice. 
The Pharmacopoeia has recommended wood charcoal ; animal is still 
better, as it has greater power for absorbing the infecting material 
thrown off in the slough. It prevents noisome odors from foul, or 
gangrenous surfaces, by absorbing the gases. It must be frequently 
applied, and should be used in all cases of gangrenous ulceration. 



*Note. — The Formulae of most of these cataplasms are taken from the 
British Pharmacopoeia. 



MANUAL OF BAND AG TNG. 127 

CATAPLASMA CONII— ( Hemlock Poultice). 

Formula. — Take of powdered hemlock leaves, one ounce ; linseed meal, 
three ounces ; boiling water, ten fluid-ounces. Mix the hemlock and meal 
intimately together, and then gradually add the water, constantly stirring. 

Uses. — As an anodyne dressing for cancerous and syphilitic 
ulceration. As there is danger of the drug being absorbed too freely 
from the wounded surface, the patient should be watched closely 
that no poisonous symptoms may arise. 

Opium and Belladonna may also be made use of in making these 
anodyne dressings, using them, however, in much smaller amounts 
than is recommended to be taken of the conium. 

CATAPLASMA FERMENTI {Yeast Poultice). 

Formula. — Take of beer yeast, six fluid-ounces ; wheat flour, fourteen 
ounces; water (100° F.), six fluid-ounces. Mix the yeast with the water, and 
stir in the flour, afterwards placing the mass before the fire till it rises. 

Uses. — As a sort of an anodyne poultice. The carbonic acid 
gas evolved has something of an anaesthetic effect upon the inflamed 
skin. It corrects the fetor of the discharges, and stimulates indolent 
ulcers. The dressing is not now much made use of. 

CATAPLASMA LINI— ( Linseed Meal Poultice). 

Formula. — Take of linseed meal, four ounces ; olive oil, one-half of a 
fluid-ounce ; boiling water, ten fluid-ounces. Mix the meal gradually with 
the water, constantly stirring it, and then gradually add the oil. 

Uses. — As a general emollient dressing. The Pharmacopoeia 
recommends the incorporation of oil in the cataplasma, because it 
is understood that the " pressed " meal is to be used. If the un- 
pressed meal, which, perhaps is best, is employed, the oil is un- 
necessary. 

This poultice may be made anodyne, antiseptic or stimulating, 
just as the surgeon may fancy, by the addition of drugs producing 
these several effects. 

CATAPLASMA SINAPIS— {Mustard Poultice). 

Formula. — Take of powdered mustard-seed and linseed, each, two and 
one-half ounces; boiling water, ten fluid-ounces. Mix the linseed meal 
gradually with the water, and then stir in the mustard. 

Uses. — More especially as a rubefacient. The Pha7'macopceia 
has directed that boiling water be used. It would be better not to 



128 CATAPLASMATA. 

employ water at so high a heat, as it deteriorates its rubefacient 
power in some varieties of mustard. The laity often make an addi- 
tion of vinegar ; but this is a mistake, in case the black mustard be 
used, as it defeats the very action it was put in to enhance. 

Care should also be had in the application of this rubefacient to 
the very young or very aged ; for if left too long applied, epidermal 
sloughing may occur. 

CATAPLASM A SOD^E CHLOKIN AT^— ( Chlorine Poultice). 

Formula. — Take of solution of chlorinated soda, two fluid-ounces ; lin- 
seed meal, four ounces ; boiling water, eight fluid-ounces. Mix the linseed 
meal gradually with the water, then add the solution of soda, with constant 
stirring. 

Uses. — This is properly a disinfectant application, and makes 
most an excellent dressing for foul and gangrenous ulcers. 

Carbolic, or, perhaps better, Salicylic acid, is a useful adjuvant 
to the common linseed, and bread-and-milk, poultices, having both 
an antiseptic and disinfectant action, besides a therapeutical and 
anaesthetical one. Tar is also sometimes incorporated in these 
styles of dressings, and makes an important ingredient, in a certain 
class of eczematous cases. 

CATAPLASM A PANIS ET LACTIS— Bread-and-Milk Poultice). 

Description. — Take the inside of a loaf of stale bread, crumble 
it well up in eight or ten ounces of sweet milk, and, after soaking a 
few minutes, let it come to a boil, and then stir in a bit of lard, or a 
few drachms of sweet oil. 

Uses. — As an emollient dressing. Anodynes may be added as 
suits the case. Is not a very commendable poultice, as, from the 
heat, etc., of the inflamed part, the milk soon becomes rancid. 

POULTICE OF OAKUM. 

Description. — Take a sufficient quantity of oakum, loosely 
picked, and place in a thin piece of muslin and wrap loosely up; 
then immerse the whole in boiling water. It is then wrung out and 
covered by a thin layer of muslin, and is thus to be applied to the 
member diseased. 

Uses. — As an antiseptic and absorptive dressing. The water 
may be charged with antiseptics or anodynes. 



MANUAL OF BANDAGING. 129 

HOW TO SPREAD A POULTICE. 

The batter of the poultice having been prepared, it is necessary 
to have a piece of thick cotton cloth, or linen, two or three inches 
wider than the surface you wish to cover with the cataplasma. 
Spreading this smoothly out upon a flat surface, you pour the batter 
upon it, and with a spatula you spread it, to a proper thickness, 
evenly over the cloth, having care that it does not come to within 
an inch or two of its edge, You then fold each edge of the cloth 
evenly over the edge of the applied batter, thus leaving a clean, neat 
margin to your cataplasm, as well as effecting a sort of a confine- 
ment of the batter to the cloth. You now spread a very thin piece 
of muslin (the thinner the better) over the whole surface of the 
poultice ; this prevents any of the meal from drying upon your 
patient's person, and ensures him a neat, clean and comfortable 
dressing. 

Some surgeons, however, prefer a coating of sweet oil over the 
spread poultice-batter to the thin piece of muslin. This also keeps 
the meal from adhering to the skin. 

HOW TO APPLY A POULTICE. 

Everything being in readiness, the poultice is lifted from the 
table, and one end gently laid upon the tender and inflamed surface, 
and the remainder of the poultice suffered gradually to cover over 
the diseased member ; with this little care you will often save your 
patient much needless pain and suffering, that would else be caused 
by "slapping" your dressing upon a tender and sensitive part. The 
same gentleness should be used in lifting a poultice ; otherwise, 
from the quick relief of pressure, a severe throbbing pain will ensue. 

After the cataplasm has been properly placed, it, and a portion 
of the member, should be covered with a piece of oil-silk, thin 
table oilcloth, or oiled muslin, and over this should be thrown a 
layer or so of flannel, the whole finally being lightly confined by a 
proper bandage. The oiled silk, or muslin, serves a double purpose ; 
that of confining the heat or moisture to the part, and of protecting 
the bed clothes, or clothing, from the water in the poultice-batter. 



IZEsTDEiX. 



Arm-sling, ordinary, 69. 

Bandages in general, 19. 

classification of, 24. 

regional classification of, 25. 

compound, 25. 

simple, 25. 

of the head, 26. 

of the neck, 47. 

of the upper extremity, 54. 

of the body, 72. 

of the lower extremity, 86. 
Binocle, 29. 
Boulette, 14. 
Bourdonnet, 14. 
Bavarian plaster splint, 112. 
Bonnet, triangular, of the head, 31. 
of the nates, 108. 
Bourse of the mamma, 79. 

of the scrotum, 110. 



Capote, 110, 120. 
Caputina, 99. 
Cataplasma carbonis, 126. 

conii, 127. 

fermenti, 127. 

lini, 127. 

sinapis, 127. 

sodffi chlorinate, 128. 

panis et lactis, 128. 

how to spread a, 129. 

how to apply a, 129. 
Charpie, 13. 
Circular of the forehead and eyes, 26. 

of the neck, 47. 
Circular-quadrilateral of the chest, and 
dorsal cervico-sternal triangle, 73. 

of the abdomen, and the dorsal cer- 
vico-sternal triangle, 74. 

of the abdomen and thorax, and the 
dorsal cervico-sternal triangle, 74. 
Common plaster dressing, 114. 
Compresses, 16. 

button-hole, 17. 

circular, 16. 



complex, 17. 

graduated pyramidal, 16. 

graduated regular, 16. 

perforated, 17, 

rectangular, 16. 

sling, 17. 

square, 16. 

triangular, 16. 

of two heads, 17. 

of three heads, 17. < 

of four heads, 17. 

of six heads, 17. 
Cotton-wool, 13. 
Cravat, cervical, 47. 

carpo-olecranon, 64. 

cervico-ulnar, and triangle, 66. 

of the neck and axilla, 75. 

simple biaxillary, 77. 

compound biaxillary, 77. 

simple dorsal biaxillary, 82. 

compound dorsal biaxillary, 82. 

simple sternal biaxillary, 84. 

compound sternal biaxillary, 85. 

popliteal, 90. 

of the knee, 90. 

tarso-patellar, 100. 

tarso-crural, 101. 

tarso-pelvic, 102. 

eruro- pelvic, 106. 

inguinal, 106. 

sacro-bicrural, 106. 

perinseal, 107. 
Cross, Maltese, 20. 

of the eye, 28. 

of the eyes, 29. 

simple, of the chin, 32. 

of the head, 34. 

of the head, Mayor's, 38. 

posterior, of the head and neck, 45. 

of the occiput, 45. 

of the mamma, 78. 

of the two mammae, 80. 

of the groin, 103. 

Emplastrum resinse, 117. 

Fenestrated immovable dressings, 116. 



INDEX. 



131 



Figure-of-S, posterior, of the head and 
axillte, 47. 

anterior, of the head and axillae, 49. 

of the head and axilla, 52. 

posterior, of the hand and wrist, 55. 

anterior, of the hand and wrist, 56. 

extensor of the hand upon the fore- 
arm, 63. 

flexor of the hand upon the forearm, 63 

anterior, of the elbow, 65. 

posterior, of the elbow, 66. 

posterior, double, of the elbow and op- 
posite axilla, 70. 

of the neck and axilla, 75. 

of the shoulder and the opposite 
axilla, 76. 

posterior, of the shoulders, 81. 

anterior, of the shoulders, 83. 

of one toe, 86. 

of the foot and ankle, 87. 

posterior, of the knee, 89. 

anterior, of the knee, 90. 

spiral, of the extremities, 93. 

bandage, of the extremities, 94. 
Fillet, or head-band, 27. 
Four-tailed bandage of the chin, 33. 

of the head and neck, 46. 

of the hand, 57. 

of the elbow, 66. 

of the shoulder, 68. 

of the instep, 88. 

of the heel, 88. 
of the leg, 95. 

of the knee, 92. 

of the hip, 108. 
Front, triangular, of the forearm, 69. 
small, of the hand or forearm, 69. 

Gateau, 13. 

Gauntlet, of the hand, 61. 
of the foot, 86. 

Handkerchief bandage, 41. 
Harelip bandage, 43. 
Head-band, 27. 
Mayor's, 30. 

Immovable dressings, 112. 
Invaginated roller, of the upper lip, 43. 

of the under lip, 44. 
Invaginated triangle, of the upper lip, 45. 

of the under lip, 45. 

Knot, surgeon's, 123. 

reef, 123. 

" granny," 123. 

clove-hitch, 124. 

M. Gerdy's extension, 125. 
Knots, 123. 
Knotted bandagejof the head, 36. 



Lateral bandage of the neck, 52. 
Maltese cross, 20. 

for thigh stump, 98. 

for leg stump, 99. 

for arm stump, 99. 
Monocle, 28. 

Parrafin baudage, 116. 

Pelote, 14. 

Plaster, adhesive, 117. 

bandage, Pirogoff's, 114. 
Plumasseau, 13. 
Posterior "star " bandage, 81. 
Poultice, charcoal, 126. 

hemlock, 127. 

yeast, 127. 

linseed meal, 127. 

mustard, 127. 

chlorine, 128. 

bread-and-milk, 128. 

oakum, 128. 

how to spread a, 129. 

how to apply a, 129. 

Recurrent bandage, of the head, 39. 

for amputated thigh, 97. 

for amputated leg, 97. 

for amputated forearm, 97. 

for amputated arm, 97. 
Reverses, how to make, 22. 
Roller, a, 20. 

how to make, 21. 

how to apply, 22. 

how to confine, 23. 

of the chin, 32. 

invaginated, of the upper lip, 43. 
of the under lip, 44. 

of the superior extremity, 65. 

cap of the knee, 91. 
Rosette stump dressing, 99. 

Sheath, of the fingers, 62. 

of the foot, 80. 
Silica bandage, 116. 
Six-tailed bandage of the head, 40. 
Skull-cap, 26. 
Sling, of the face, 27. 

of the chin, 33. 

of the head, 40. 

of the occiput, 66. 

of the hand, 57. 

large, triangular, of the arm, 68. 

small, of the hand or forearm, 69. 
of the instep, 89. 
of the heel, 88. 

for the superior extremity, 103. 
Spica, of the shoulder, 75. 

descending, of the shoulder, 76. 

ascending, of the shoulder, 76. 

of the toes, 86. 



132 



INDEX. 



ascending, of the groin, 103. 

descending, of the groin, 104. 

of the thumb, 55. 
Spiral, of the neck, 47. 

of one finger, 54. 

of all the fingers, 61. 

of the fingers and the hand, 62. 

simple, of the forearm, 65. 

reversed, of the superior extremity, 65. 

of the arm, 67. 

of the chest, 72. 

of the abdomen, 73. 

of one toe, 86. 

of all the toes, 86. 

of the foot, 87. 

of the knee, 91. 

simple, of the leg, 92. 

of the thigh, 92. 

reversed, of the leg, 93. 
of the thigh, 93. 

figure-of-8, of the extremities, 93. 

reversed, of the inferior extremity, 96. 
Starch, or plaster, roller, 115. 
Strappings, 117. 

for the foot and ankle, 118. 

for wounds, 119. 

for the testicle, 120. 

for the breast, 121. 

for extension of the leg, 122. 
Suspensory bandage of the scrotum, 109. 



T of the head and ear, 36. 
7 of the temple, 36. 
perforated, of the head and ear, 37. 
double, of the nose, 41. 
of the mouth, 42. 
double, posterior, of the head and 

thorax, 49. 
double, anterior, of the head and 

thorax, 50. 
double, of the back of the hand and 

wrist. 57. 
single, of the back of the hand and 

wrist, 58. 
perforated, of the hand and wrist, 59. 



double, anterior, of hand and wrist, 60. 

single, anterior, of hand and wrist, 60. 

double, of the toes and ankle, 86. 

trapezoidal, of the groin, 104. 

double, of the perinseum, 107. 

single, of the perinaeum, 107. 

double, of the trunk, 111. 
Tampon, 14. 
Temple bandage, 34. 
Tents, 14. 

Testudo of the knee, 91. 
Triangle, of the face, 29. 

of the eye, 29. 

fronto-oculo-occipital, 30. 

fron to-occipital, 31. 

occipito-frontal, 31. 

biparietal, 31. 

occipito-mental, 34. 

of the chin, 34. 

occipito-auricular, 38. 

of the head, 41. 

fronto-cervico-labial. 45. 

fronto-dorsal, 49. 

occipito-sternal, 51. 

parieto-axillary, and cravat, 52. 

lateral, of the neck, 52. 

carpo-digito-palmar, 59. 

carpo-digito-dorsal, 60. 

of the elbow, 66. 

large oblique, of the arm and chest, 68. 

anterior, thoracico-scapular, 74. 

posterior, thoracico-scapular, 74. 

of the mamma, 79. 

bimammary, 81. 

of the foot, 88. 

of the leg, 95. 

for thigh stump, 98. 

for leg stump, 98. 

for arm stump, 98. 

scapulo-tibial, and cravat, 102. 

cruro-inguinal, 105. 

cruro-pelvic, 105. 

sacro-pubic, 108. 

coxo-pelvic, 108. 

lumbo-scrotal, 109. 
Tubes caoutchouc vulcanise, 110, 120. 



ADVEKTISEMENTS. 




.HE Patrons of these pages have assured me that they will cheerfully 
answer all inquiries that may be addressed them in reference to their 
special departments — that all orders will be as promptly and conscien- 
tiously filled if received by mail, as if delivered in person. They are 
all well known and reliable firms, and you need have no hesitancy in ordering 
of them. C. H. L. 




2^^£^<7 



Ss 



PATENT 



Union Artificial Limbs, 




ARE FURNISHED TO 

Officers, Soldiers, Seamen, and Marines, who are in need 
of, and entitled thereto, together with Transportation to 
and from either of the Manufactories, free of charge, as 
per contract with the Surgeon General of the United 
States Army. 

Jl large illustrated descriptive pamphlet, 

Giving a view and Full Description of the Limbs, Complimentary Notices from the Press. Certi- 
ficates from Surgeons, Portraits and Post Office Address of many difficult Double Amputation 
Cases, who are now wearing a pair of them, and Testimonials from those who have previously 
tried the various kind of limbs : also much other information which is valuable to Surgeons and 
those who contemplate using them, bent Free on Application. 

Surgeons who wish, to beep Informed of New Improvements, 
and those who have lost limbs and have not received a pamphlet printed in or since 1875, are 
pabticulaklt KEQUE8TED to send for one. 

I am the ONLY PATENTEE and MANUFACTURER IN AMERICA (Perhaps in the World) 
who wears a full length Artificial Leg and was a Practical Mechanician at the time 
of amputation. If I, with these qualifications and long experience, cannot tell what is necessary 
in an Artificial Limb, WHO CAN ? 

ADDRESS 1013 Chestnut Street, Philadelphia, Pa. 

' 60 West Fourth Street, Cincinnati, Ohio. 

JAMES A, FOSTER, 73 CIark street ( Cor - Randolph), Chicago, Ills. 

Or 72 Griswold Street (Cor. Larned), Detroit, Mich. 



PARKE, DAVIS & CO., 



Jpiittfjadtirittij 




ID IE T IR, O I T . 



Manufacturers of 



FLUID AND SOLID EXTRACTS 
SUGAR COATED PILLS, 
PURE CONCENTRATIONS, 
GRANULAR EFFERV. SALTS, 



ELIXIRS, WINES &. SYRUPS, 
AQUA AMMONI/E, 
SPIRITS NITRE DULC, 
EMPTY CAPSULES, 



CHEM, PURE CHLOROFORM, CHEMICALS, Etc., Etc. 



We call special attention to the following articles lately added to our list : 

Fluid Extract Guarana. 

Fluid Extract Eucalyptus Globulus. 

Fluid Extract Bearsfoot. 

Fluid Extract Calendula. 

Fluid Extract Chestnut Leaves. 

Fluid Extract Conium Seed. 

Fluid Extract Grindelia Robusta. 

Fluid Extract Cotton Root Bark (from the fresh root). 

Fluid Extract Stavesacre Seed. 

Pills of Picrate of Ammonium. (Sugar Coated.) 

Brundage's Anti-Constipation Pills. (Sugar Coated.) 



Send for dose, descriptive list and circulars, which will be forward on application. 

Physicians who desire our preparations will please specify P. D. & Co. on their pre- 
scriptions 

Our list of manufactures can be obtained of the following Wholesale Druggists, at 
manufacturers' rates : 



R. MACREADY & CO Cincinnati 

KENYON, POTTER & CO Syracuse, N. Y. 

GEO. A. KELLY & CO Pittsburg, Pa. 

BENTON, MYERS & CANFIELD..Cleveland, 0. 

STRONG, COBB & CO Cleveland, 0. 

GEO. M. DIXON Dayton, 0. 

ARTHUR PETER & CO Louisville, Ky. 

E. BURNHAM, SON & CO Chicago, 111. 

BROWNING & SLOAN Indianapolis, Ind. 



WHEELOCK, FINLAY & CO..New Orleans, La. 

J. W. WOOD & CO Kansas City, Mo. 

J. DURBIN Denver, Colorado 

COLBURN, BIRKS & CO Peoria, 111. 

GEO. A. EDDY Leavenworth, Kansas 

GODBE PELTS & CO. ...Salt Lake City, Utah 

REED, WILLIAMS & CO Toledo, 0. 

FARRAND WILLIAMS & CO Detroit, Mich. 

SWIFT & DODDS Detroit, Mich. 




5tt -3 



ffl 



1 ^ 

r3 -* 



o 



'S 

6 » 

1 IS 

O M 

J* ^ 

"ft ft 

ft a 



«5 "3 



SHEPARD & DUDLEY 

Importers, Manufacturers and Wholesale Dealers in 

mm\ jiisti limits afi| |afe |#?r |oo^ 



MANUFACTURERS OF 



Elastic Goods, Supporters, Chest Protectors^ Etc. 

iBstrnment Makers to the New York Eye and Ear Infirmary. 

150 William Street, NEW YORK. 




Copy of the Judges' Report, in 
Department III, Group 5, Div. A, 
at the 43d Exhibition of the 
American Institute, held in the 
City of New York, October and 
November, 1874 : 



No. Q7Q. 

SURGICAL INSTRUMENTS AND APPLIANCES. 

SHEPARD & DUDLEY, 150 William Street, New York. 

We heartily concur in commending this case of Surgical Instruments and 

Appliances, as being decidedly valuable, excellent in manufacture, equal 

to the best of its class known, reflecting great credit on the exhibitors. 

A SILVER MEDAL AWARDED. 



Henry B. Sands, M. D., Prof, of Anatomy in the College of Physicians and Surgeons, 
Surgeon to Rosevelt and Bellevue Hospitals, New York. 

Edward D. Janewat, M. D., Lecturer on Materia Medica and Therapeutics, and Clinical 
Medicine, and Physician to Bellevue Hospital. 

T. P. Gibney, M. D., Surgeon to the Hospital for Ruptured and Crippled, New York. 




Von Braun's Starch 



Shears for Removing any Immovable Dressings. 



|||iiiit|jarftti|itig pltitfitiacM 

AND IMPORTER OF 

MEDICAL MERCHANDISE. 

DEPOT FOR AMERICAN DRUGS AND THEIR PRODUCTS, 

DETFOIT, --- MICHIGAN. 

WAREHOUSE No. 89 WOODWARD AVENUE, 

Laboratory and Drug Mills, Woodbridge and Congress Sts., bet. Fifth and Sixth. 



The following NEW DRUGS are offered, Crude or Powdered, and in form of FLUID 
EXTRACT, ELIXIR, SYRUP or TINCTURE. 

DAMIANA 

The new aphrodisiac from Mexico, re- 
puted reliable for restoring virility. 

GUARANA 

New South American drug, used in 
headache, neuralgia, dysentery, nervous 
depression, etc. 

CEREUS GRANDIFLORUS 

Flowers of the night blooming cereus, 
used in functional palpitation of the 
heart. (In fluid extract and tincture, only). 

CALENDULA 

Flowers— Anti-spasmodic. 

EUCALYPTUS 

Used in intermittents, and as an aroma- 
tic antiseptic. 

GUACO 

A Venezuela plant, reputed of value as a 
diaphoretic in cholera, yellow fever, etc. 

KAMALA AND KOUSSO 

Abyssinian anthelmintics, used for ex- 
pelling tape worm. 

OENOTHERA 

Evening primrose. Alterative in skin 
diseases. 

RHAMNUS FRANGULA 

Bark of black buckthorn, valuable ca- 
thartic and aperient. 

SUMBUL 

The Bucharian musk root, is a nervous 
anodyne in delirium, hysteria, gastric 
spasms, etc. 



JABORANDI 

The new and intensely powerful sialo- 
gogue and sudorific. 

GRINDELIA 

The new Californian specific for Asthma 
and Bronchitis. 

BOLDO 

Leaves of a Chilian evergreen, used as 
an alterative in liver diseases, tonic in 
fevers. 

CHIONANTHUS 

A valuable tonic, aperient and altera 
tive in bilious and intermittent fevers. 

CAINCA 

Brazilian diuretic, for dropsy. 

C AST AN E A 

Sweet chestnut leaves, used in whoop- 
ing cough. 

FUCUS VESICULOSUS 

Used for reducing obesity. 

MALT (EXTRACT) 

Diastase, milk, malt-sugar and alkaline 
salts. Nutritious tonic. 

RICINUS, FOLIA 

Galactagogue, inducing the flow of 
mother's milk when absent. 

SILPHIUM 

Compass plant, valuable tonic and alter- 
ative. 



Catalogue No 75, a comprehensive Priced list, 132 Pages, 168 Classes, 
comprising about 10» 000 Pharmaceutical products, will be sent to any address for 
25 cents. 



Fluid Extracts, 420 kinds. 

Pills, Sugar Coated, 404 

Elixirs, 212 " 

Solid Extracts, 670 " 



Medicated Lozenges, 212 kinds . 

Resinous Substances, 220 " 

Suppositories, 121 kinds, 5 sizes. 

Powdered Drugs, 823 sorts. 



Pressed American Herbs etc. 630 kinds. Miscellaneous Products, over 7,000 kinds. 



L. BLACK & CO., 
Manufacturing Opticians, 

77 Woodward Avenue, DETROIT, MICH. 

Microscopes and Slides, 

Fever Thermometers, 
Artificial Eyes, 

Cataract Lenses, 
Magnifiers, Loupes, 
Opthalmascopes, Test Tubes, 
Philosophical Apparatus, 
Electric Batteries, etc,, etc. 

Spectacles and Eyeglasses fitted and adjusted to the failing Eyesight. 
Orders by mail will receive prompt attention. 

L. BLACK &> CO, 




Established A. D. 1843. 



W. B. KEEIST, OOOKE & CO., 

PUBLISHERS, BOOKSELLERS AND STATIONERS, 
o n i o .a. o- o. 

Medical and Surgical Publications. 

TO TEE MEDICAL PROFESSION. 

W. B KEEN, COOKE & CO.'S MEDICAL BOOK DEPARTMENT is the most 
extensive in the country. Particular attention is called to our catalogue of Medical Books 
which will he mailed Free on application. 

HOW TO PROCURE BOOKS.— We will forward per U. S. Mail and prepay postage 
upon the same, all books Aveighing four pounds and under (hooks weighing over four 
pounds are not mailable), upon receipt of Publishers' Prices, as named in our Catalogue. 

>e®=-We assume no risk upon Money or Books, although out of the many hundreds of 
volumes sent by us by mail, none to our knoAvledge have been lost. 

We will forward Books to all points reached by the Regular Express Lines, east of 
the Mississippi River, and prepay charges on the same upon receipt of Publishers' Prices. 
Money to accompany all orders. 

Jg^- When Books are forwarded per Express " Collect on Delivery " all expenses of 
freight and of returning the money, must be paid by the consignee. 

CHICAGO MEDICAL JOURNAL AND EXAMINER, 

Editor : William H. Byford, A.M., M.D. Associate Editors : James H. Etheridge, M D. 
Norman Bridge, M. D. Jas. Nevins Hyde, A. M., M. D. Ferd. C. Hotz, M.D. 

ISSUED MONTHLY. 

J5p™ Postage Free to all Subscribers in the United States. "®n 

The CHICAGO MEDICAL JOURNAL AND EXAMINER will be sent for one year to any 
Subscriber in the United States, postage prepaid by the publishers, on the receipt of 

FOUR DOLLARS PER ANNUM IN ADVANCE. 

Making a Splendid Volume each year, at the low price of Four Dollars. 

W. B. KEEN, COOKE & CO., Publishers, 

I 13 & IIS State St,, CHICAGO. 



MEDICAL BOOKS, 

10 per cent, discount, 

LITERARY and GENERAL BOOKS, 

20 per cent. Discount to the Medical Profession. 
Sign of the BOOK 
189 Woodward Overrule, Detroit. 

J. M. ARNOLD & CO. 



Orders by Mail will receive prompt attention. ]\±edical 
and Miscellaneous Books mailed post-paid on receipt of 
retail price or by Express at the discounts above, charges 
being paid by Consignee. 



FARRAND, WILLIAMS & CO.'S 

NORWEGIAN 

COD LIVEE OIL 

Is put up in pint bottles, with our firm name on the labels and over each cork. The oil 
is imported from Norway in tin lined and perfectly air tight barrels. It is made with 
scientific care at a low temperature, in order to insure its paleness, sweetness, and free- 
dom from unpleasant flavor. The delicacy and purity thus obtained, render it especially 
valuable to the invalid. A careful observation has convinced us that the oil yielded by 
the Codfish of the Norwegian Seas is preferable, in point of palatableness and'medicinal 
properties, to the Oil of Newfoundland, and this opinion has been confirmed by the re- 
cent tendency of medical and popular selection. It contains less solid fats, or stearine, 
and is therefore digested bv delicate stomachs, which cannot tolerate the coarser Oils 
which are put upon the market. 

THE NORWEGIAN GOD LIVER OIL 

Costs to import just double the price of Newfoundland Oil, yet we sell the former in bot- 
tles at as low price as the latter is sold for, and in doing so, we feel that we are confer- 
ring a boon upon the public. 

If the medical profession will designate our Oil in their prescriptions, it will give their 
patients satisfaction, and they can rest assured that the Oil is inferior to none. 



^j^euelj^istid, wtl:di.a.:m:s &c 00., 

MANUFACTUREKS OF 

MEDICINAL ELIXIRS, MEDICATED TINCTURES, SYRUPS, 

ESSENCES, WATERS, OINTMENTS, PLASTERS, 

All Warranted Officinal Strength. 

Dealers in and Importers of Pure Chemicals, Fine Powdered Drugs, Shaker's 

Serbs, Gums, Pure Essential Oils, Etc. 

JE^Turity and Quality are always of the First Consideration with us in buying and 
selling. 



LIBRARY OF CON, 



iRESS 



